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Updated: Jan 11, 2026
Gene Regulation and Targeted Therapy in Gastric Cancer Peritoneal Metastasis: Radiological Findings from Dual Energy CT and PET/CT
Published on: January 22, 2018
Predictive factors for successful conversion therapy in gastric cancer with peritoneal metastasis: a case-control
Zhongqiang Zheng1, Xuanzi Sun2
1Department of General Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.
Background:
Gastric cancer (GC) patients with peritoneal metastasis (PM) have a poor prognosis. Little is known about factors for successful conversion therapy in GC with PM. This study aimed to identify early predictive factors associated with R0 resection in GC patients with PM undergoing conversion therapy.
Methods:
We retrospectively analyzed 108 patients diagnosed with PM via laparoscopic exploration and treated systemically at The First Affiliated Hospital of Xi'an Jiaotong University (2019-2023). Prognostic outcomes were evaluated using Kaplan-Meier analysis, and logistic regression was employed to identify factors influencing conversion therapy success.
Results:
In total, 108 patients with PM were included in the study, 21 of whom underwent R0 resection after conversion therapy (R0 resection rate, 19.4%). Patients in the conversion surgery (CS) group had a significantly longer median overall survival than those in the non-CS group (P<0.001). Multivariate analysis revealed that elevated carbohydrate antigen 125 (CA125) levels [odds ratio (OR): 5.449, 95% confidence interval (CI): 1.425-20.830; P=0.01] were a risk factor for the failure of conversion therapy in GC patients with PM. Treatment with a programmed death 1 (PD-1) inhibitor (OR: 0.285, 95% CI: 0.099-0.820, P=0.02) was a protective factor against the failure of conversion therapy in GC patients with PM.
Conclusions:
Achieving R0 resection through conversion therapy can significantly improve the prognosis of GC patients with PM. For patients with no significant elevation of CA125, it is advisable to consider implementing an aggressive first-line regimen in conjunction with a PD-1 inhibitor for the purpose of conversion therapy.
