{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T10:29:12Z","timestamp":1788863352565,"version":"build-2803163510"},"reference-count":29,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2020,1,1]],"date-time":"2020-01-01T00:00:00Z","timestamp":1577836800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>The present study demonstrated prognostic factors for long-term survival in patients after a comprehensive treatment (CHT) for peritoneal metastasis (PM) from gastric cancer (GC). Materials and Methods: Among 419 patients treated with neoadjuvant intraperitoneal\/systemic chemotherapy (NIPS), 266 (63.5%) patients received complete resection (CC-0) of the macroscopic tumors. In total, 184 (43.9%) patients were treated with postoperative systemic chemotherapy. Results: All patients treated who received incomplete cytoreduction (CC-1) died of GC within 6 years. In contrast, 10- year survival rates (-YSR) of CC-0 resection were 8.3% with median survival time (MST) of 20.5 months. Post-NIPS peritoneal cancer index (PCI) \u226411, and pre-NIPS PCI \u226413 were the significant favorable prognostic factors. Patients with numbers of involved peritoneal sectors \u22645 survived significant longer than those with \u22656. Both negative pre- and post-NIPS cytology was associated with significant favorable prognosis. Multivariate analyses identified pre-PCI (\u226413 vs. \u226514), and cytology after NIPS (negative cytology vs. positive cytology) as independent prognostic factors. Ten year-survivors were found in patients with involvement of the greater omentum (9%), pelvic peritoneum (3%), para-colic gutter (13.9%), upper jejunum (5.6%), lower jejunum (5.5%), spermatic cord (21.9%), rectum (9.5%), ureter (6.3%), ovary (6.7%), and diaphragm (7.0%) at the time of cytoreduction. Twenty-one patients survived longer than 5 years, and 17 patients are still alive without recurrence. Conclusions: GC-PM should be removed aggressively, in patients with PCI after NIPS \u226411, PCI before NIPS \u226413, mall bowel PCI \u22642, and complete cytoreduction should be performed for metastasis in \u22645 peritoneal sectors.<\/jats:p>","DOI":"10.3390\/cancers12010116","type":"journal-article","created":{"date-parts":[[2020,1,3]],"date-time":"2020-01-03T11:55:07Z","timestamp":1578052507000},"page":"116","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":37,"title":["Long Term Survival after Cytoreductive Surgery Combined with Perioperative Chemotherapy in Gastric Cancer Patients with Peritoneal Metastasis"],"prefix":"10.3390","volume":"12","author":[{"given":"Yutaka","family":"Yonemura","sequence":"first","affiliation":[{"name":"NPO to Support Peritoneal Surface Malignancy Treatment, Japanese\/Asian School of Peritoneal Surface Oncology, Kyouto 600-8189, Japan"},{"name":"Department of Regional Cancer Therapy, Peritoneal Surface Malignancy Center, Kishiwada Tokushukai Hospital, Kishiwada 596-8522, Japan"},{"name":"Department of Regional Cancer Therapy, Peritoneal Surface Malignancy Center, Kusatsu General Hospital, Shiga 525-8585, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aruna","family":"Prabhu","sequence":"additional","affiliation":[{"name":"NPO to Support Peritoneal Surface Malignancy Treatment, Japanese\/Asian School of Peritoneal Surface Oncology, Kyouto 600-8189, Japan"},{"name":"Department of Regional Cancer Therapy, Peritoneal Surface Malignancy Center, Kishiwada Tokushukai Hospital, Kishiwada 596-8522, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shouzou","family":"Sako","sequence":"additional","affiliation":[{"name":"NPO to Support Peritoneal Surface Malignancy Treatment, Japanese\/Asian School of Peritoneal Surface Oncology, Kyouto 600-8189, Japan"},{"name":"Department of Regional Cancer Therapy, Peritoneal Surface Malignancy Center, Kishiwada Tokushukai Hospital, Kishiwada 596-8522, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haruaki","family":"Ishibashi","sequence":"additional","affiliation":[{"name":"Department of Regional Cancer Therapy, Peritoneal Surface Malignancy Center, Kishiwada Tokushukai Hospital, Kishiwada 596-8522, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akiyoshi","family":"Mizumoto","sequence":"additional","affiliation":[{"name":"Department of Regional Cancer Therapy, Peritoneal Surface Malignancy Center, Kusatsu General Hospital, Shiga 525-8585, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nobuyuki","family":"Takao","sequence":"additional","affiliation":[{"name":"Department of Regional Cancer Therapy, Peritoneal Surface Malignancy Center, Kusatsu General Hospital, Shiga 525-8585, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masumi","family":"Ichinose","sequence":"additional","affiliation":[{"name":"Department of Regional Cancer Therapy, Peritoneal Surface Malignancy Center, Kusatsu General Hospital, Shiga 525-8585, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shunsuke","family":"Motoi","sequence":"additional","affiliation":[{"name":"Department of Regional Cancer Therapy, Peritoneal Surface Malignancy Center, Kusatsu General Hospital, Shiga 525-8585, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yang","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Regional Cancer Therapy, Peritoneal Surface Malignancy Center, Kishiwada Tokushukai Hospital, Kishiwada 596-8522, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazurou","family":"Nishihara","sequence":"additional","affiliation":[{"name":"NPO to Support Peritoneal Surface Malignancy Treatment, Japanese\/Asian School of Peritoneal Surface Oncology, Kyouto 600-8189, Japan"},{"name":"Department of Regional Cancer Therapy, Peritoneal Surface Malignancy Center, Kishiwada Tokushukai Hospital, Kishiwada 596-8522, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1990-2584","authenticated-orcid":false,"given":"Andreas","family":"Brandl","sequence":"additional","affiliation":[{"name":"Digestive Unit, Champalimaud Foundation, 1400-038 Lisbon, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5567-7383","authenticated-orcid":false,"given":"Sachio","family":"Fushida","sequence":"additional","affiliation":[{"name":"Department of Surgery, Kanazawa University, Kanazawa 920-8641, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2020,1,1]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2395","DOI":"10.1200\/JCO.2004.08.154","article-title":"Multivariate prognostic factor analysis in locally advanced and metastatic esophago-gastric cancer\u2014Pooled analysis from three multicenter, randomized controlled trials using individual patient data","volume":"22","author":"Chau","year":"2004","journal-title":"J. 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