[Treatment for advanced gastric cancer with positive lavage cytology-systemic versus intraperitoneal chemotherapy]

The prognosis of advanced gastric cancer patients complicated with positive lavage cytology is poor, similar with that of peritoneal dissemination. For these diseases, we had reported the usefulness of intraperitoneal chemotherapy with cisplatin. Recently, systemic chemotherapy with S-1 and cisplatin is effective even for gastric cancer with peritoneal dissemination. Therefore, we compared the combination chemotherapy of S-1 and intraperitoneal cisplatin (IP group) with systemic S-1 plus cisplatin chemotherapy (IV group) for positive lavage cytology without peritoneal dissemination (P0CY1) gastric cancer. In this trial, 8 patients were enrolled after gastrectomy. Four were IP group and another 4 were IV group. The average chemotherapy courses for IV group and IP group are 3.5 times and 4.8 times, respectively. There was no difference in prognosis. Grade 3/4 events occurred for IV group and IP group were 3 patients and only 1 patient, respectively. The combination chemotherapy of S-1 and intraperitoneal cisplatin was found to be well tolerated and effective in patients with advanced gastric cancer with P0CY1.