Reappraisal of Peritoneal Washing Cytology in 984 Patients with Pancreatic Ductal Adenocarcinoma Who Underwent Margin-Negative Resection

Sohei Satoi, Yoshiaki Murakami, Fuyuhiko Motoi, Kenichiro Uemura, Manabu Kawai, Masanao Kurata, Masayuki Sho, Ippei Matsumoto, Hiroaki Yanagimoto, Tomohisa Yamamoto, Masamichi Mizuma, Michiaki Unno, Yasushi Hashimoto, Seiko Hirono, Hiroki Yamaue, Goro Honda, Minako Nagai, Yoshiyuki Nakajima, Makoto Shinzeki, Takumi FukumotoA. Hon Kwon

Research output: Contribution to journalArticlepeer-review

23 Citations (Scopus)

Abstract

Results: Significant correlations between CY+ and high CA19-9 level, pancreatic body and tail cancer, lymph node metastasis, and a lower frequency of R0 resection were observed. Overall survival (OS) of CY+ patients was significantly worse than that of CY− patients (median survival time [MST], 16 vs. 25 months; 3-year OS rate, 6 vs. 37 %; p < 0.001). CY+ patients had a significantly higher rate of post-operative peritoneal carcinomatosis than CY− patients (48 vs. 21 %; p < 0.001). Administration of adjuvant chemotherapy did not provide a favorable survival outcome to CY+ patients. The current study showed that patients with M1 disease had acceptable MST after margin-negative resection and a high incidence of peritoneal carcinomatosis within 3 years after surgery, resulting in decreased long-term survival. The development of a new strategy to control peritoneal carcinomatosis when surgical resection is performed in such patients is required.

Objective: The objective of the present study was to reappraise the clinical value of peritoneal washing cytology (CY) in 984 pancreatic ductal adenocarcinoma patients who underwent margin-negative resection.

Methods: In a 2001–2011 database from seven high-volume surgical institutions in Japan, 69 patients (7 %) had positive CY (CY+ group) indicative of M1 disease and 915 patients had negative CY (CY− group). Clinicopathological data and survival were compared between groups.

Original languageEnglish
Pages (from-to)6-14
Number of pages9
JournalJournal of Gastrointestinal Surgery
Volume19
Issue number1
DOIs
Publication statusPublished - 2014 Jan

Keywords

  • Adjuvant chemotherapy
  • Pancreatic ductal adenocarcinoma
  • Peritoneal carcinomatosis
  • Peritoneal washing cytology
  • Survival analysis

ASJC Scopus subject areas

  • Surgery
  • Gastroenterology

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