{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T14:34:53Z","timestamp":1790174093138,"version":"4.1.0"},"reference-count":36,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2024,6,9]],"date-time":"2024-06-09T00:00:00Z","timestamp":1717891200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Funda\u00e7\u00e3o de Amparo \u00e0 Pesquisa do Estado de S\u00e3o Paulo (FAPESP agency)","award":["2020\/13249-0"],"award-info":[{"award-number":["2020\/13249-0"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medical Sciences"],"abstract":"<jats:p>Gastric cancer (GC) with peritoneal carcinomatosis (PC) has a particularly unfavorable prognosis. This limited survival raises doubts about which factors confer an extremely worse outcome and which patients could benefit from more aggressive treatments, in an attempt to improve survival and better control the disease. This study aimed to evaluate the survival outcomes of patients with PC due to GC and develop a prognostic score to predict 6-month mortality. We performed an analysis of clinical stage IV GC with PC. Scores were assigned to risk factors and calculated for each patient from nine variables. Among 326 IVB GC, 211 (64.7%) had PC and were included. After calculating the score, 136 (64.5%) GCs were classified as a low-risk group and 75 (35.5%) as a high-risk group. Median OS was 7.9 and 1.9 months for low- and high-risk patients (p &lt; 0.001). In the high-risk group, 77.3% of the patients died in &lt;6 mo (p &lt; 0.001). Palliative surgery and chemotherapy were associated with better survival, and the prognostic groups maintained statistical significance even when the same type of treatment was performed. In conclusion, the scoring system developed with variables related to patient performance status and clinical data was able to distinguish GC with PC with a high risk of 6-month mortality. Accordingly, verifying and validating our findings in a large cohort of patients is necessary to confirm and guarantee the external validation of the results.<\/jats:p>","DOI":"10.3390\/medsci12020030","type":"journal-article","created":{"date-parts":[[2024,6,10]],"date-time":"2024-06-10T08:59:06Z","timestamp":1718009946000},"page":"30","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Risk Scoring System to Predict Mortality in Gastric Cancer with Peritoneal Carcinomatosis"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6865-0988","authenticated-orcid":false,"given":"Marina Alessandra","family":"Pereira","sequence":"first","affiliation":[{"name":"Department of Gastroenterology, Instituto do Cancer, Hospital das Cl\u00ednicas da Faculdade de Medicina da Universidade de S\u00e3o Paulo, S\u00e3o Paulo 01249-000, Brazil"},{"name":"Department of Gastroenterology, Instituto do Cancer, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Av. Dr. Arnaldo, 251, S\u00e3o Paulo 01246-000, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0200-7858","authenticated-orcid":false,"given":"Marcus Fernando Kodama Pertille","family":"Ramos","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Instituto do Cancer, Hospital das Cl\u00ednicas da Faculdade de Medicina da Universidade de S\u00e3o Paulo, S\u00e3o Paulo 01249-000, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amir Zeide","family":"Charruf","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Instituto do Cancer, Hospital das Cl\u00ednicas da Faculdade de Medicina da Universidade de S\u00e3o Paulo, S\u00e3o Paulo 01249-000, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andr\u00e9 Roncon","family":"Dias","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Instituto do Cancer, Hospital das Cl\u00ednicas da Faculdade de Medicina da Universidade de S\u00e3o Paulo, S\u00e3o Paulo 01249-000, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1711-7347","authenticated-orcid":false,"suffix":"Jr.","given":"Ulysses","family":"Ribeiro","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Instituto do Cancer, Hospital das Cl\u00ednicas da Faculdade de Medicina da Universidade de S\u00e3o Paulo, S\u00e3o Paulo 01249-000, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,6,9]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"209","DOI":"10.3322\/caac.21660","article-title":"Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries","volume":"71","author":"Sung","year":"2021","journal-title":"CA A Cancer J. Clin."},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Japanese Gastric Cancer Association (JGCA) (2021). Japanese gastric cancer treatment guidelines 2018 (5th edition). Gastric Cancer, 24, 1\u201321.","DOI":"10.1007\/s10120-020-01042-y"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"e1648","DOI":"10.1590\/0102-672020210002e1648","article-title":"Surgical Treatment in Clinical Stage IV Gastric Cancer: A Comparison of Different Procedures and Survival Outcomes","volume":"35","author":"Ramos","year":"2022","journal-title":"Arq. Bras. De Cir. Dig."},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Manzanedo, I., Pereira, F., P\u00e9rez-Viejo, E., and Serrano, \u00c1. (2023). Gastric Cancer with Peritoneal Metastases: Current Status and Prospects for Treatment. Cancers, 15.","DOI":"10.3390\/cancers15061777"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"864647","DOI":"10.3389\/fonc.2022.864647","article-title":"Gastric Cancer With Peritoneal Metastasis\u2014A Comprehensive Review of Current Intraperitoneal Treatment Modalities","volume":"12","author":"Prabhu","year":"2022","journal-title":"Front. Oncol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1005","DOI":"10.1016\/j.annonc.2022.07.004","article-title":"Gastric cancer: ESMO Clinical Practice Guideline for diagnosis, treatment and follow-up","volume":"33","author":"Lordick","year":"2022","journal-title":"Ann. Oncol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"687","DOI":"10.1016\/S0140-6736(10)61121-X","article-title":"Trastuzumab in combination with chemotherapy versus chemotherapy alone for treatment of HER2-positive advanced gastric or gastro-oesophageal junction cancer (ToGA): A phase 3, open-label, randomised controlled trial","volume":"376","author":"Bang","year":"2010","journal-title":"Lancet"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"948647","DOI":"10.3389\/fimmu.2022.948647","article-title":"Recent Progress and Future Perspectives of Immunotherapy in Advanced Gastric Cancer","volume":"13","author":"Jin","year":"2022","journal-title":"Front. Immunol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1575","DOI":"10.1245\/s10434-011-1631-5","article-title":"Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy improves survival of patients with peritoneal carcinomatosis from gastric cancer: Final results of a phase III randomized clinical trial","volume":"18","author":"Yang","year":"2011","journal-title":"Ann. Surg. Oncol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"209","DOI":"10.3109\/07357907.2012.654871","article-title":"Peritoneal carcinomatosis: Cytoreductive surgery and HIPEC--overview and basics","volume":"30","author":"Piso","year":"2012","journal-title":"Cancer Investig."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"622","DOI":"10.1245\/s10434-023-14379-2","article-title":"Cytoreduction and Hyperthermic Intraperitoneal Paclitaxel and Cisplatin for Gastric Cancer with Peritoneal Metastasis","volume":"31","author":"Buckarma","year":"2024","journal-title":"Ann. Surg. Oncol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"3750","DOI":"10.1245\/s10434-024-15102-5","article-title":"Initial Experience Using Laparoscopic HIPEC for Gastric Cancer with Peritoneal Metastasis: Safety and Outcomes","volume":"31","author":"Read","year":"2024","journal-title":"Ann. Surg. Oncol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"e1435","DOI":"10.1590\/0102-672020190001e1435","article-title":"Conversion therapy for gastric cancer: Expanding the treatment possibilities","volume":"32","author":"Ramos","year":"2019","journal-title":"Arq. Bras. De Cir. Dig."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"e1744","DOI":"10.1590\/0102-672020230026e1744","article-title":"Intraperitoneal chemotherapy for gastric cancer with peritoneal carcinomatosis: Study protocol of a phase II trial","volume":"36","author":"Ramos","year":"2023","journal-title":"Arq. Bras. De Cir. Dig."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"425","DOI":"10.1007\/s11605-016-3336-3","article-title":"Conversion Surgery Post-Intraperitoneal Paclitaxel and Systemic Chemotherapy for Gastric Cancer Carcinomatosis Peritonei. Are We Ready?","volume":"21","author":"Chan","year":"2017","journal-title":"J. Gastrointest. Surg."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"50","DOI":"10.21037\/tgh.2016.05.12","article-title":"Conversion therapy for stage IV gastric cancer-the present and future","volume":"1","author":"Yamaguchi","year":"2016","journal-title":"Transl. Gastroenterol. Hepatol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"298","DOI":"10.14740\/wjon1578","article-title":"Gene Expression Profile-Guided Personalized Intraperitoneal Chemotherapy for Gastric Cancer Peritoneal Carcinomatosis","volume":"15","author":"Markovich","year":"2024","journal-title":"World J. Oncol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"163","DOI":"10.3892\/mco.2017.1128","article-title":"Long-term survival and prognosis associated with conversion surgery in patients with metastatic gastric cancer","volume":"6","author":"Einama","year":"2017","journal-title":"Mol. Clin. Oncol."},{"key":"ref_19","first-page":"173","article-title":"Prognostic factors in metastatic gastric carcinoma","volume":"41","author":"Marrekchi","year":"2019","journal-title":"Exp. Oncol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"373","DOI":"10.1016\/0021-9681(87)90171-8","article-title":"A new method of classifying prognostic comorbidity in longitudinal studies: Development and validation","volume":"40","author":"Charlson","year":"1987","journal-title":"J. Chronic Dis."},{"key":"ref_21","unstructured":"Amin, M.B., Edge, S., Greene, F., Byrd, D.R., Brookland, R.K., Washington, M.K., Gershenwald, J.E., Compton, C.C., Hess, K.R., and Sullivan, D.C. (2017). AJCC Cancer Staging Manual, American Joint Commission on Cancer. [8th ed.]."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"329","DOI":"10.1007\/s10120-015-0575-z","article-title":"Is conversion therapy possible in stage IV gastric cancer: The proposal of new biological categories of classification","volume":"19","author":"Yoshida","year":"2016","journal-title":"Gastric Cancer"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1111\/ajco.13025","article-title":"Metastatic gastric cancer: Does the site of metastasis make a difference?","volume":"15","author":"Tan","year":"2019","journal-title":"Asia-Pac. J. Clin. Oncol."},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Rijken, A., Lurvink, R.J., Luyer, M.D.P., Nieuwenhuijzen, G.A.P., van Erning, F.N., van Sandick, J.W., and de Hingh, I. (2021). The Burden of Peritoneal Metastases from Gastric Cancer: A Systematic Review on the Incidence, Risk Factors and Survival. J. Clin. Med., 10.","DOI":"10.3390\/jcm10214882"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"935","DOI":"10.5306\/wjco.v12.i10.935","article-title":"Jejunostomy in the palliative treatment of gastric cancer: A clinical prognostic score","volume":"12","author":"Ramos","year":"2021","journal-title":"World J. Clin. Oncol."},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Chen, X.J., Chen, G.M., Wei, Y.C., Yu, H., Wang, X.C., Zhao, Z.K., Luo, T.Q., Nie, R.C., and Zhou, Z.W. (2021). Palliative Gastrectomy versus Gastrojejunostomy for advanced Gastric cancer with outlet obstruction: A propensity score matching analysis. BMC Cancer, 21.","DOI":"10.1186\/s12885-021-07904-7"},{"key":"ref_27","first-page":"2079","article-title":"Gastrectomy for Stage IV Gastric Cancer. A Systematic Review and Meta-analysis","volume":"34","author":"Lasithiotakis","year":"2014","journal-title":"Anticancer. Res."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"1371","DOI":"10.1007\/s10147-023-02384-0","article-title":"Clinical significance of intraperitoneal paclitaxel combined with systemic chemotherapy for gastric cancer with peritoneal metastasis","volume":"28","author":"Nakashima","year":"2023","journal-title":"Int. J. Clin. Oncol."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"277","DOI":"10.1016\/S1470-2045(03)01074-X","article-title":"Intraperitoneal antineoplastic drug delivery: Rationale and results","volume":"4","author":"Markman","year":"2003","journal-title":"Lancet Oncol."},{"key":"ref_30","first-page":"2299","article-title":"Prognostic significance of palliative gastrectomy in incurable advanced gastric cancer: A retrospective cohort study and meta-analysis","volume":"25","author":"Zheng","year":"2021","journal-title":"Eur. Rev. Med. Pharmacol. Sci."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"851","DOI":"10.1002\/jso.25036","article-title":"Neutrophil-lymphocyte ratio is associated with prognosis in patients who underwent potentially curative resection for gastric cancer","volume":"117","author":"Szor","year":"2018","journal-title":"J. Surg. Oncol."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"660","DOI":"10.1002\/ags3.12386","article-title":"An ascites grading system for predicting the prognosis of gastric cancer with peritoneum dissemination","volume":"4","author":"Honda","year":"2020","journal-title":"Ann. Gastroenterol. Surg."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1007\/s11605-019-04462-z","article-title":"Return to Intended Oncologic Treatment (RIOT) in Resected Gastric Cancer Patients","volume":"24","author":"Ramos","year":"2019","journal-title":"J. Gastrointest. Surg."},{"key":"ref_34","doi-asserted-by":"crossref","unstructured":"Chen, X.J., Wei, C.Z., Lin, J., Zhang, R.P., Chen, G.M., Li, Y.F., Nie, R.C., and Chen, Y.M. (2023). Prognostic Significance of PD-L1 Expression in Gastric Cancer Patients with Peritoneal Metastasis. Biomedicines, 11.","DOI":"10.3390\/biomedicines11072003"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"117","DOI":"10.5230\/jgc.2014.14.2.117","article-title":"Initial clinical experience with cytoreductive surgery and hyperthermic intraperitoneal chemotherapy in signet-ring cell gastric cancer with peritoneal metastases","volume":"14","author":"Horvath","year":"2014","journal-title":"J. Gastric. Cancer"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"758","DOI":"10.1002\/jso.25379","article-title":"Signet ring cell features with peritoneal carcinomatosis in patients undergoing cytoreductive surgery and hyperthermic intraperitoneal chemotherapy are associated with poor overall survival","volume":"119","author":"Solomon","year":"2019","journal-title":"J. Surg. Oncol."}],"container-title":["Medical Sciences"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2076-3271\/12\/2\/30\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T14:56:13Z","timestamp":1760108173000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2076-3271\/12\/2\/30"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,6,9]]},"references-count":36,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2024,6]]}},"alternative-id":["medsci12020030"],"URL":"https:\/\/doi.org\/10.3390\/medsci12020030","relation":{},"ISSN":["2076-3271"],"issn-type":[{"value":"2076-3271","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,6,9]]}}}