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Implications of peritoneal lavage cytology in resectable left-sided pancreatic cancer
Yoshifumi Iwagami1, Hidetoshi Eguchi, Hiroshi Wada
1Department of Surgery, Graduate School of Medicine, Osaka University, Yamadaoka 2-2 (E2), Suita, Osaka, 565-0871, Japan, yiwagami@gesurg.med.osaka-u.ac.jp.
Purpose:
The aim of this study was to determine the utility of the peritoneal lavage cytology findings in predicting the clinical outcomes of resectable left-sided pancreatic cancer.
Methods:
Peritoneal lavage samples were collected from 39 consecutive patients who underwent surgery for left-sided pancreatic cancer between January 2000 and December 2010. We analyzed the correlations between the peritoneal lavage cytology findings and the clinical outcomes.
Results:
Five patients (12.8 %) had malignant cells in the cytology samples (positive cytology). This occurred more frequently in patients with vascular invasion (P = 0.008). Positive cytology was significantly associated with lower overall (P = 0.0007) and recurrent-free (P < 0.0001) survival rates. Positive cytology was an independent prognostic factor for recurrence (P = 0.022); it was closely associated with local recurrence, peritoneal recurrence and distant metastasis.
Conclusion:
Surgeons should carefully consider the intraoperative diagnosis of peritoneal lavage cytology in patients with resectable left-sided pancreatic cancers, because patients with positive cytology are likely to experience recurrence.
