Peritoneal Lavage in Gastric Carcinoma

Jaehne, Joachim; Hj, Meyer; Soudah, B.; Maschek, H.; Pichlmayr, R.

doi:10.1159/000171878

Cited by 28 publications

(18 citation statements)

References 5 publications

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“…In a subgroup of the Dutch Gastric Cancer Study (Bonenkamp et al, 1996), which is presently the single largest study of this topic in the Western world, among completely (R0-UICC) resected patients, there was detection rate of FPTC in 4% of patients, with an additional 1% diagnosed as suspicious for malignancy. In a smaller series, in tumours operated upon according to the guidelines of the GGCS (Roder et al, 1995), as was our study, Jaehne et al (1989) found a rate of 11% for FPTC. In the remaining studies of FPTC in gastric carcinoma, which are almost exclusively from Asia, rates of 14% (Koga et al, 1984) and 22% (Chen and Liu, 1994) are quoted for patients who have had a ÔcurativeÕ resection according to the guidelines of the JRSGC (Japanese Research Society for Gastric Cancer, 1981).…”

Section: Fptc: Frequency Conventional Cytologysupporting

confidence: 76%

“…However, it has been demonstrated in cases of definite tumour involvement of the gastric serosa without metastatic peritoneal implants, that only from 12% (Bonenkamp et al, 1996) to 22% (Chen and Liu, 1994) of cases have detectable free tumour cells. With an established peritoneal carcinosis, the rate of positive cytological diagnoses ranges from 50% (Jaehne et al, 1989) to 81% (Kaibara et al, 1987), with the provision that the rate of positive diagnosis is dependent on the extent of peritoneal carcinosis and, more importantly, on the presence of ascites.…”

Section: Fptc: Frequency Conventional Cytologymentioning

confidence: 99%

“…In past studies using conventional lavage cytology in patients with a complete tumour resection, peritoneal carcinosis has been shown to be more frequent when free peritoneal tumour cells were detected preoperatively (Nakajima et al, 1978;Koga et al, 1984;Asao et al, 1989;Jaehne et al, 1989;Iitsuka et al, 1990;Nishiyama et al, 1995;Bonenkamp et al, 1996). For this reason, it was recently proposed on a trial basis by the International Union Against Cancer (UICC) (UICC, 1993) that tumours with conventional cytological evidence of peritoneal involvement should be classified as pM1, with the provision that this is a cytological finding (Hermanek and Wittekind, 1995).…”

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confidence: 99%

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Immunocytochemically detected free peritoneal tumour cells (FPTC) are a strong prognostic factor in gastric carcinoma

et al. 1999

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SummaryWe prospectively investigated the prognostic significance of free peritoneal tumour cells (FPTC) in a series of 118 patients with completely resected gastric carcinoma. Immunocytochemistry with the monoclonal antibody Ber-Ep4 was performed on cytospins from intraoperative peritoneal lavage specimens. Twenty-three patients (20%) had FPTC which was significantly correlated with pT and pN categories, stage, tumour size, lymphatic invasion, Laurèn and WHO classifications and perigastric adipose tissue metastases. The median survival time for all FPTC positive compared with negative patients was significantly shorter (11 compared with > 72 months), with estimated 5-year survival rates of 8% vs. 60%. None of the patients with FPTC had an early gastric cancer. In advanced tumour subgroups without and with serosal invasion (n = 59 and 35), there were 19% and 34% with FPTC. Multivariate survival analysis showed nodal status, FPTC, mesenteric lymphangiosis, and lymph node metastasis to the compartment III to be independent prognostic factors with relative risks of 6.6, 4.5, 2.9 and 2.2 respectively. Recurrent disease occurred in 91% of FPTC-positive and in 38% of FPTC-negative patients. FPTC had a positive predictive value of 91% and a specificity of 97% for tumour recurrence. FPTC is a strong negative, independent prognostic indicator for survival in gastric carcinoma.

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Section: Fptc: Frequency Conventional Cytologysupporting

confidence: 76%

Section: Fptc: Frequency Conventional Cytologymentioning

confidence: 99%

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confidence: 99%

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Immunocytochemically detected free peritoneal tumour cells (FPTC) are a strong prognostic factor in gastric carcinoma

et al. 1999

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“…3,4 Peritoneal dissemination is the most frequent pattern of recurrence in gastric cancer after potentially curative resection, and no efficient method of treatment is available. [5][6][7][8][9][10] Such recurrences may be attributable to possible intraperitoneal dissemination of malignant cells at the microscopic level, already present at the time of surgery, or due to surgical manipulations. [5][6][7]9,11 Peritoneal lavage as a diagnostic/staging method has not yet been definitely included in the management of gastrointestinal carcinomas, although pancreas, colon, and gastric cancers are quite often associated with ascites and/or intraperitoneal free tumor cells at the time of the initial diagnosis.…”

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confidence: 99%

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

Ribeiro

Safatle‐Ribeiro

Zilberstein

et al. 2006

Journal of Gastrointestinal Surgery

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“…After a median follow-up period of 12.5 months patients with disseminated tumor cells had a lower survival rate than patients without tumor cells. In der Vergangenheit wurde dem Tumorzellnachweis in der Peritoneallavage mit konventioneller zytologischer I Technik bei gastrointestinalen Tumoren Aufmerksamkeit iI geschenkt [12,16,26,28]. Mit der Etablierung und Ver-III IV besserung immunzytochemischer Techniken und der kommerziellen Herstellung zahlreicher Antik6rper ist es inzwischen jedoch m6glich, wesentlich empfindlicher Tumorzellen nachzuweisen [9,20,27].…”

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Tumorzelldissemination in das Knochenmark und in die Peritonealhohle eine immunzytochemische Untersuchung an Patienten mit einem Magen- oder kolorektalen Karzinom

Broll

Lembeke

Stock

et al. 1996

Langenbecks Arch Chir

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The tumor spread and the radicality of surgical resection are the most important facts in a patient's prognosis. In spite of curative tumor resection many patients die from metastases or local tumor recurrence. One possible reason is early dissemination of tumor cells which cannot be detected with clinical methods of examination. For this reason the aim of our study was to examine both bone marrow and peritoneal lavage for disseminated tumor cells with an immunocytochemical technique in patients with a gastrointestinal carcinoma. We also wanted to find out whether there was any correlation between the incidence of tumor cell detection and the TNM classification, staging and tumor grading and whether disseminated tumor cells have any prognostic significance. Our study included 54 patients who underwent surgery in our clinic for a carcinoma of the stomach (20 patients) or the colorectum (34 patients) from November 1993 to December 1994. At the beginning of the operation bone marrow had been taken from the iliac spine, and the abdomen was irrigated with 1000 ml saline solution immediately after laparotomy or laparoscopy. After cell separation with Ficoll density centrifugation 5 x 10(5) cells were applied per slide by a cytospin technique. For detection of the tumor cells we used the APAAP technique and the following monoclonal antibodies: KL1, CK2, anti-CEA, 17-1A (bone marrow) and Ber-EP4, B72.3, anti-CEA and 17-1A (peritoneal lavage). Altogether 77% of all patients had tumor cells in the bone marrow and 69% in peritoneal lavage fluid. It was possible to detect tumor cells in bone marrow (67%) and peritoneal lavage fluid (25%) even of patients with T1 tumors. The percentage increased with depth of wall infiltration. There was a marked difference in bone marrow aspirates between patients with lymph-node-negative tumors (N0) and those with lymph-node-positive tumors (N+): 65% had tumor cells in N0 and 85% in N+ stages. This trend was also seen in patients with (M1) and without (M0) metastases, in both bone marrow aspirates and peritoneal lavage fluid. In bone marrow there was a good correlation of tumor cells with staging, but in peritoneal lavage fluid this was not so. Finally, we detected tumor cells more often in bone marrow and peritoneal lavage fluid of patients with poorly differentiated tumors (G3) or diffuse Lauren type than in patients with moderately differentiated tumors (G2) or intestinal Lauren type. After a median follow-up period of 12.5 months patients with disseminated tumor cells had a lower survival rate than patients without tumor cells.

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Peritoneal Lavage in Gastric Carcinoma

Cited by 28 publications

References 5 publications

Immunocytochemically detected free peritoneal tumour cells (FPTC) are a strong prognostic factor in gastric carcinoma

Immunocytochemically detected free peritoneal tumour cells (FPTC) are a strong prognostic factor in gastric carcinoma

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

Tumorzelldissemination in das Knochenmark und in die Peritonealhohle eine immunzytochemische Untersuchung an Patienten mit einem Magen- oder kolorektalen Karzinom

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