Does the Intraoperative Peritoneal Lavage Cytology Add Prognostic Information in Patients With Potentially Curative Gastric Resection?

Ribeiro, Ulysses; Safatle‐Ribeiro, Adriana Vaz; Zilberstein, Bruno; Mucerino, Donato Roberto; Yagi, Osmar Kenji; Bresciani, Claudio; Jacob, Carlos Eduardo; Iryia, Kiyoshi; Gama-Rodrigues, Joaquim

doi:10.1016/j.gassur.2005.11.001

Cited by 63 publications

(39 citation statements)

References 23 publications

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“…Multivariable Cox regression found PWC to be one of the most significant independent predictors of survival. Positive PWC as an independent predictor of survival has been previously reported by many investigators [2,3,6,[8][9][10][11][12][13][14]24] with a mean survival time of 8.6-18.4 months [1,7,8,17,20,24,32]. However, the influence of positive PWC on the survival of patients with gastric cancer has not been consistent.…”

Section: Discussionmentioning

confidence: 95%

“…The relatively high false-negative rate might imply technical flaws such as incomplete sampling in the lavage process. False-positive PWC has also been recognized, with a rate of 4.5%-5.0%, probably due to the presence of reactive mesothelial cells [20,21,26]. To reduce the false-negative rate, several authors have introduced more sensitive methods for detecting peritoneal dissemination, including immunohistochemistry and molecular biology techniques such as reverse transcriptase-polymerase chain reaction (RT-PCR) for expressing carcinoembryonic antigen (CEA) mRNA [20,24,[27][28][29][30] or trypsinogen mRNA [31] in the peritoneal washing fluid.…”

Section: Discussionmentioning

confidence: 99%

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Prognostic significance of peritoneal washing cytology in Thai patients with gastric adenocarcinoma undergoing curative D2 gastrectomy

Euanorasetr

Lertsithichai

2007

Gastric Cancer

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Section: Discussionmentioning

confidence: 95%

Section: Discussionmentioning

confidence: 99%

Prognostic significance of peritoneal washing cytology in Thai patients with gastric adenocarcinoma undergoing curative D2 gastrectomy

Euanorasetr

Lertsithichai

2007

Gastric Cancer

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“…Twenty-four articles provided data on 2-year overall survival [21-32, 34-36, 38-40, 42-44, 46-48], while six articles reported 5-year overall survival rates [23,32,33,37,39,40]. All articles found that overall survival was significantly reduced for patients with positive IFCCs.…”

Section: Peritoneal Recurrence Rates By Detection Of Ifccsmentioning

confidence: 99%

A systematic review of the accuracy and utility of peritoneal cytology in patients with gastric cancer

et al. 2011

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Background There is lack of uniformity in the utilization of peritoneal cytology in gastric cancer management. The identification of intraperitoneal free cancer cells (IFCCs) is believed to confer poor prognosis. However, while some of these patients are palliated, others may undergo more aggressive therapies. In this review, we aimed to identify and synthesize findings on the use of peritoneal cytology in predicting peritoneal recurrence and overall survival in curative gastric cancer patients. Methods Electronic literature searches were conducted using Medline, EMBASE, and the Cochrane Central Register of Controlled Trials from January 1, 1998 to December 31, 2009. We determined the accuracy, sensitivity, and specificity of peritoneal cytology in predicting peritoneal recurrence based on four techniques-conventional cytology, immunoassay, immunohistochemistry, and reverse transcriptase-polymerase chain reaction. Recurrence rates and overall survival rates for curative patients were determined, based on positivity or negativity for IFCCs. Results Twenty-eight articles were included. All four techniques showed wide variations in accuracy, sensitivity, and specificity in predicting peritoneal recurrence. Recurrence rates for patients positive for IFCCs ranged from 11.1 to 100%, while those negative for IFCCs had recurrence rates of 0-51%. Overall survival was significantly reduced for patients with positive IFCCs. Short follow-up periods and possible duplication of results may limit result interpretation. Conclusion The presence of IFCCs appears to increase the risk of peritoneal recurrence and is associated with worse overall survival in gastric cancer patients. Further incorporation of peritoneal cytology in clinical decisionmaking in gastric cancer depends on the development of a consistently accurate and rapid IFCC detection method.

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“…It is thought that these cells are present in the peritoneal cavity as a result of cell shedding from the primary tumour where it involves the serosa. [5][6][7][8] However, positive peritoneal cytology has also been observed in patients with T1 and T2 tumours when it is believed that perforating lymphatic channels may explain the presence of malignant cells in the peritoneal cavity. 9 Importantly, positive peritoneal cytology has been shown repeatedly to be an independent poor prognostic indicator in gastric and oesophageal cancers.…”

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confidence: 99%

The Current Role of Staging Laparoscopy in Oesophagogastric Cancer

Convie

Thompson

Kennedy

et al. 2015

annals

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INTRODUCTION Oesophagogastric cancers are known to spread rapidly to locoregional lymph nodes and by transcoelomic spread to the peritoneal cavity. Staging laparoscopy combined with peritoneal cytology can detect advanced disease that may not be apparent on other staging investigations. The aim of this study was to determine the current value of staging laparoscopy and peritoneal cytology in light of the ubiquitous use of computed tomography in all oesophagogastric cancers and the addition of positron emission tomography in oesophageal cancer. METHODS All patients undergoing staging laparoscopy for distal oesophageal or gastric cancer between March 2007 and August 2013 were identified from a prospectively maintained database. Demographic details, preoperative staging, staging laparoscopy findings, cytology and histopathology results were analysed. RESULTS A total of 317 patients were identified: 159 (50.1%) had gastric adenocarcinoma, 136 (43.0%) oesophageal adenocarcinoma and 22 (6.9%) oesophageal squamous carcinoma. Staging laparoscopy revealed macroscopic metastases in 36 patients (22.6%) with gastric adenocarcinoma and 16 patients (11.8%) with oesophageal adenocarcinoma. Positive peritoneal cytology in the absence of macroscopic peritoneal metastases was identified in a further five patients with gastric adenocarcinoma and six patients with oesophageal adenocarcinoma. There was no significant difference in survival between patients with macroscopic peritoneal disease and those with positive peritoneal cytology (p=0.219). CONCLUSIONS Staging laparoscopy and peritoneal cytology should be performed routinely in the staging of distal oesophageal and gastric cancers where other investigations indicate resectability. Currently, in our opinion, patients with positive peritoneal cytology should not be treated with curative intent.

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Does the Intraoperative Peritoneal Lavage Cytology Add Prognostic Information in Patients With Potentially Curative Gastric Resection?

Cited by 63 publications

References 23 publications

Prognostic significance of peritoneal washing cytology in Thai patients with gastric adenocarcinoma undergoing curative D2 gastrectomy

Prognostic significance of peritoneal washing cytology in Thai patients with gastric adenocarcinoma undergoing curative D2 gastrectomy

A systematic review of the accuracy and utility of peritoneal cytology in patients with gastric cancer

The Current Role of Staging Laparoscopy in Oesophagogastric Cancer

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