Relationship between Peritoneal Washing Cytology through Implantable Port System (IPS-Cytology) and Second-Look Laparotomy in Ovarian Cancer Patients with Unmeasurable Residual Diseases

Yamauchi, Hideaki; Yoshida, Takashi; Suzuki, Shinya; Oda, Takashi; Kohno, Ichiro

doi:10.1006/gyno.1998.5075

Cited by 9 publications

(5 citation statements)

References 13 publications

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“…Last but not the least, PW cytopathology through implantable port system (IPS-cytology) can also detect intraperitoneal persistent disease in patients with unmeasurable residual ovarian cancer receiving chemotherapy [9]. …”

Section: Discussionmentioning

confidence: 99%

“…The subsequent widespread acceptance and routine use of the procedure was reflected in its incorporation into the 1976 report of FIGO. In the 33 years since its official incorporation into the FIGO surgical staging system of ovarian carcinoma, many authors have confirmed the diagnostic and prognostic utility of obtaining PW cytopathology [8,9,10,11,12]. Since its introduction more than 50 years ago, the PW has gained widespread acceptance and is used routinely at most centers.…”

Section: Introductionmentioning

confidence: 99%

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Significance of Peritoneal Washing Cytopathology in Ovarian Carcinomas and Tumors of Low Malignant Potential: A Quality Control Study with Literature Review

Özkara

2010

Acta Cytologica

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Objective: The author evaluated a consecutive group of peritoneal washings (PWs) performed in the evaluation of adnexal masses to determine whether the conventional histopathologic prognostic parameters significantly affect the tumor detection rate using this procedure. Study Design: Cytopathologic reports from all PWs performed over a 13-year (1996–2008) period in the evaluation of malignant and borderline ovarian tumors were reviewed and correlated with those of the synchronously obtained histopathologic specimens. Tumors of low malignant potential (LMP) were separated for analysis. Statistical significance was determined using the χ² test. Results: In the study, a total of 134 PWs were associated with primary epithelial malignant tumors (n = 114) or tumors of LMP (n = 20) involving the ovary. The positive PW cytopathology rates for clear cell (83.3%), undifferentiated (80.0%), and serous carcinomas (65.7%) were higher than the overall average positive rate (62.3%) for all histopathologic subtypes. In contrast, endometrioid (41.2%) and mucinous (45.5%) carcinomas had markedly lower cytopathology-positive rates than the overall average positive rate (p = 0.118). As expected, PWs were found to be significantly more likely to yield malignant cells in higher-grade (grades II + III, 71.1%, p = 0.002) and higher-stage (stages III + IV) tumors (76.6%, p = 0.000) than in lower-grade (grade I, 38.7%) and lower-stage (stages I + II) tumors (32.4%) and also in tumors with lymph node involvement (72.7%, p = 0.021) than in tumors without lymph node involvement (46.7%) and in bilateral tumors (74.6%, p = 0.004) than in unilateral tumors (42.9%). The positive cytopathology rates for the PWs of the corresponding primary ovarian carcinomas with prominent pleomorphism (81.0%, p = 0.007), with high mitotic score (80.0%, p = 0.006) and solid architecture (72.9%, p = 0.122) were also higher than the overall average positive rate. The overall sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and efficiency for the ovarian carcinoma (n = 114) cases were 72.3, 85, 95.8, 39.5 and 74.6%, respectively. The positive cytopathology rate for the PWs of the serous tumors of LMP (7.1%) was higher than that of the mucinous tumors of LMP (0.0%) and the overall average positive cytopathology rate (5.0%) for the ovarian tumors with LMP. The calculated sensitivity, specificity, PPV, NPV, and efficiency for tumors of LMP were 33.3, 100, 100, 89.5, and 90%, respectively. Conclusion: PW cytopathology results correlate significantly with almost all of the conventional histopathologic prognostic parameters and the cyto-histomorphologic parameters of the corresponding primary ovarian carcinomas. The positive cytopathology rates also differ according to the histopathologic subtypes. False negativity and ‘false positivity?’ was significantly correlated with tumor grade.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Significance of Peritoneal Washing Cytopathology in Ovarian Carcinomas and Tumors of Low Malignant Potential: A Quality Control Study with Literature Review

Özkara

2010

Acta Cytologica

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“…Obtaining peritoneal washings through an intra-peritoneal Port-a-Cath at periodic intervals is another modality of disease reassessment. Fujiwara et al [42] studied the use of peritoneal washings with second-look laparotomy.…”

Section: Detection Of Recurrencementioning

confidence: 99%

Recurrent ovarian carcinoma: Is there a place for surgery?

Chen

Karlan

2000

Semin. Surg. Oncol.

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“…In addition, this port was effective in evaluating the response to chemotherapy and to determine the timing of surgical resection. The effectiveness of the abdominal port was previously reported for ovarian cancer, which revealed high accuracy of cytology (sensitivity: 0.82, specificity: 1.00, positive predictive value: 1.00, negative predictive value: 0.88) in 40 patients 22. Although further studies are needed to confirm the accuracy of this examination in PC, serial examination using abdominal port cytology might aid in assessing the response to chemotherapy with the aim of conversion surgery.…”

Section: Discussionmentioning

confidence: 55%

Conversion surgery for positive peritoneal washing cytology in pancreatic cancer

et al. 2019

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Positive peritoneal washing cytology (PPC) of pancreatic carcinoma is defined as distant metastasis in the American Joint Committee on Cancer or Union for International Cancer Control’s tumour, node, metastases classification. However, surgical resection was believed to be the only method that prolong survival; thus, many institutions perform pancreatectomy for PPC, despite the unfavourable prognosis. Therefore, a more preferable alternative treatment for PPC is required. A 64-year-old man with resectable pancreatic tail cancer presented to our hospital. PPC was detected at first laparotomy; thus, pancreatectomy was avoided and gemcitabine with nabpaclitaxel (GnP) was administered. After four courses of GnP treatment, PPC converted to negative, as evaluated by abdominal port cytology. Thus, distal pancreatectomy was performed, and R0 resection was achieved. He has been healthy for more than 24 months since the first laparotomy. Initial chemotherapy with the intention of converting the cytological status followed by surgical treatment might become a useful treatment strategy for PPC.

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Relationship between Peritoneal Washing Cytology through Implantable Port System (IPS-Cytology) and Second-Look Laparotomy in Ovarian Cancer Patients with Unmeasurable Residual Diseases

Cited by 9 publications

References 13 publications

Significance of Peritoneal Washing Cytopathology in Ovarian Carcinomas and Tumors of Low Malignant Potential: A Quality Control Study with Literature Review

Significance of Peritoneal Washing Cytopathology in Ovarian Carcinomas and Tumors of Low Malignant Potential: A Quality Control Study with Literature Review

Recurrent ovarian carcinoma: Is there a place for surgery?

Conversion surgery for positive peritoneal washing cytology in pancreatic cancer

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