Positive Intraoperative Peritoneal Lavage Cytology is a Negative Prognostic Factor in Pancreatic Ductal Adenocarcinoma: A Retrospective Single-Center Study

Hirabayashi, Kenichi; Imoto, Akiko; Yamada, Misuzu; Hadano, Atsuko; Kato, Nobuaki; Miyajima, Yoko; Ichikawa, Hitoshi; Kawaguchi, Yoshindo; Nakagohri, Toshio; Mine, Tetsuya; Nakamura, Naoya

doi:10.3389/fonc.2015.00182

Cited by 25 publications

(21 citation statements)

References 18 publications

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“…Previous studies report median OS of 10–11 months in pancreatic cancer patients with positive peritoneal cytology, compared with 16–27 months in those with negative cytology 9, 22 . This re-emphasizes that positive cytology identifies microscopic peritoneal disease and signifies tumor dissemination.…”

Section: Discussionmentioning

confidence: 97%

Percutaneous Peritoneal Lavage for the Rapid Staging of Gastric and Pancreatic Cancer

et al. 2017

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Background Positive peritoneal cytology (PC) is classified as M1 disease in gastric and pancreatic cancer. While PC is typically obtained by laparoscopic peritoneal lavage (PL), this study sought to examine the feasibility and safety of performing this percutaneously, with monitored anesthesia care and in combination with other diagnostic procedures to condense and expedite the staging process. Methods Patients with gastric or pancreatic cancer scheduled for laparoscopy with PL were prospectively enrolled to undergo intraoperative percutaneous PL prior to laparoscopic PL. Saline was infused through a percutaneously-inserted catheter and fluid was collected for PC. Three-quadrant washings collected during laparoscopy were also sent for PC. The primary outcome was to evaluate the sensitivity and specificity of percutaneous PL for detecting positive PC compared with the gold standard of laparoscopic PL. The secondary outcome was to determine safety. Results Percutaneous PL was successfully performed in 70 of 76 patients (92%). Ten of 48 gastric cancer patients (21%) and three of 22 pancreatic cancer patients (14%) had positive percutaneous and laparoscopic PC. Two additional gastric cancer patients had positive laparoscopic PC only. Sensitivity and specificity of percutaneous compared to laparoscopic PL was 87% and 100%, respectively. No complications occurred with percutaneous PL. Conclusions Percutaneous PL is a safe and effective minimally-invasive alternative to laparoscopic PL for the diagnosis of metastatic gastric and pancreatic cancer. It is possible this can be utilized in an outpatient setting, such as during endoscopy, to allow for earlier diagnosis of M1 disease and decreased time to appropriate treatment.

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Section: Discussionmentioning

confidence: 97%

Percutaneous Peritoneal Lavage for the Rapid Staging of Gastric and Pancreatic Cancer

et al. 2017

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“…The significance of positive peritoneal cytology in pancreatic cancer is similar to gastric cancer, with decreased survival, again, regardless of resection status 3,21 . Previous studies report median OS of 10-11 months in pancreatic cancer patients with positive peritoneal cytology, compared with 16-27 months in those with negative cytology 9,22 . This reemphasizes that positive cytology identifies microscopic peritoneal disease and signifies tumor dissemination.…”

Section: Discussionmentioning

confidence: 98%

Percutaneous Peritoneal Lavage for the Rapid Staging of Gastric and Pancreatic Cancer

Linda

Coit

Allen

et al. 2016

Journal of the American College of Surgeons

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Background-Positive peritoneal cytology (PC) is classified as M1 disease in gastric and pancreatic cancer. While PC is typically obtained by laparoscopic peritoneal lavage (PL), this study sought to examine the feasibility and safety of performing this percutaneously, with monitored anesthesia care and in combination with other diagnostic procedures to condense and expedite the staging process. Methods-Patients with gastric or pancreatic cancer scheduled for laparoscopy with PL were prospectively enrolled to undergo intraoperative percutaneous PL prior to laparoscopic PL. Saline was infused through a percutaneously-inserted catheter and fluid was collected for PC. Threequadrant washings collected during laparoscopy were also sent for PC. The primary outcome was to evaluate the sensitivity and specificity of percutaneous PL for detecting positive PC compared with the gold standard of laparoscopic PL. The secondary outcome was to determine safety. Results-Percutaneous PL was successfully performed in 70 of 76 patients (92%). Ten of 48 gastric cancer patients (21%) and three of 22 pancreatic cancer patients (14%) had positive percutaneous and laparoscopic PC. Two additional gastric cancer patients had positive laparoscopic PC only. Sensitivity and specificity of percutaneous compared to laparoscopic PL was 87% and 100%, respectively. No complications occurred with percutaneous PL. Conclusions-Percutaneous PL is a safe and effective minimally-invasive alternative to laparoscopic PL for the diagnosis of metastatic gastric and pancreatic cancer. It is possible this can be utilized in an outpatient setting, such as during endoscopy, to allow for earlier diagnosis of M1 disease and decreased time to appropriate treatment.

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“…In this study, we determined large tumor size, poor tumor differentiation and BRPHC were the independent predictors favoring extended lymphadenectomy. Tumor size has been repeatedly reported to be a crucial prognostic factor for patients with pancreatic cancer (32)(33)(34)(35)(36), in relation to positive peritoneal lavage cytology (37) and recurrence (38,39). It is thought that cells within the tumor usually acquire mutations, and nally, a sub-clone that is capable of lymph node metastasis may evolve as the primary tumor grows.…”

Section: Discussionmentioning

confidence: 99%

Extended lymphadenectomy benefits patients with borderline resectable pancreatic head cancer —— a single-center retrospective study

Zhu

Lyu

Wang

et al. 2020

Preprint

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Background: Whether standard lymphadenectomy or extended lymphadenectomy should be performed is still under debate during pancreaticoduodenectomy (PD). We aimed to compare their morbidity and mortality rates among patients with pancreatic head cancer (PHC). Material and methods: In this retrospective study, a total of 322 patients were enrolled. According to the scope of intraoperative lymph node dissection, patients were divided into extended lymphadenectomy group (n=120) and standard lymphadenectomy group (n=202). Based on the resectability of the tumor, there were 198 cases of resectable PHC and 124 cases of boardline resectable PHC, respectively, in which further stratified analysis was carried out according to the extent of lymph node dissection.Results: All patients completed the operation successfully, with a perioperative morbidity rate of 27.9% and mortality rate of 0.9%. As for the overall patients, patients in the extended lymphadenectomy group had higher NLR, longer operation time, more intraoperative blood loss, lymph node dissection and patients with BRPHC. (P<0.05) The 1-, 2- and 3-year overall survival rates of patients with extended lymphadenectomy and standard lymphadenectomy were 71.9%, 50.6%, 30.0% and 70.0%, 32.9%, 21.5%, respectively. (P=0.068) With regards to patients with BRPHC, the number of lymph node dissection in the extended lymphadenectomy group was more, (P<0.05) and the 1-, 2- and 3-year overall survival rates of patients with extended lymphadenectomy and standard lymphadenectomy were 60.7%, 43.3%, 27.4% and 43.2%, 17.7%, 17.7%, respectively. (P=0.007)Conclusions: Patients with BRPHC tended to have vast lymph node metastasis. Extended lymphadenectomy can improve their long-term survival.

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Positive Intraoperative Peritoneal Lavage Cytology is a Negative Prognostic Factor in Pancreatic Ductal Adenocarcinoma: A Retrospective Single-Center Study

Cited by 25 publications

References 18 publications

Percutaneous Peritoneal Lavage for the Rapid Staging of Gastric and Pancreatic Cancer

Percutaneous Peritoneal Lavage for the Rapid Staging of Gastric and Pancreatic Cancer

Percutaneous Peritoneal Lavage for the Rapid Staging of Gastric and Pancreatic Cancer

Extended lymphadenectomy benefits patients with borderline resectable pancreatic head cancer —— a single-center retrospective study

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