Significance of peritoneal cytology in patients with gastric cancer: a mono institutional experience with 50 patients

Abstract

34histologically proven gastric cancer cases. All patients who were found to have definitive organ metastasis on preoperative imaging were excluded from the study. Study techniqueAll 50 patients underwent exploratory laparotomy via long midline incision. On opening the abdomen, 500 ml sterile normal saline was instilled into the peritoneal cavity which was manually dispersed by shaking the abdomen. The primary tumour was not touched.A washing sample (100 ml) was aspirated from the peritoneal cavity. The specimen was immediately carried to the department of pathology, were sample was centrifuged to make smears which were fixed and stained with PAP (Papanicolau) stain and the slides examined under light microscope.Peritoneal cytology was considered positive when malignant cancer cells were found in the smears. Medical records of each patient were then reviewed in detail and relevant clinical and pathological information were obtained .The patients were then followed for recurrence of disease and mortality either in our follow up clinic or by telephonic conversation. Associations between cytology status (CY) and clinicopathological variables and effect of cytology status on overall survival was evaluated. Study toolsPre structured questionnaire, preoperative staging investigations, pathology reports, cytology result. Data analysisDetailed history and examination and all relevant results were recorded using pre structured data sheet, the final pathology and cytology results were obtained and patient were followed up for an average of 15 months. All these data was entered into a Microsoft soft excel sheet and a master chart was prepared. This was used for making tables and diagrams to represent the data. Statistical correlation was done and tests of significance was calculated. Statistical analysis was done using statistical software R, version 2.13.0.