Would you consider a D2 gastrectomy in young fit patients with gastric adenocarcinoma and positive peritoneal cytology without macroscopic disease if cytology turned negative after neoadjuvant chemotherapy?  

Negative peritoneal mycology plus very good objective response in the primary in a very young and healthy patient would be reasonable to remove the primary with the understanding there is still a significant risk of well over fifty percent of not curing the patient. This is a very highly selective s...