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Peritoneal washing cytology status as a crucial prognostic determinant in patients with localized pancreatic ductal adenocarcinoma who underwent curative-intent resection following preoperative chemoradiotherapy

  • 0Department of Hepatobiliary Pancreatic and Transplant Surgery, Mie University Graduate School of Medicine, Tsu, Mie, Japan.
Plos One +

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September 6, 2024

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September 6, 2024

View abstract on PubMed

Summary

This summary is machine-generated.

Positive peritoneal washing cytology (CY+) in pancreatic cancer patients after chemoradiotherapy (CRT) indicates poor prognosis. This finding is an independent predictor of worse survival and recurrence, highlighting its clinical significance.

Area Of Science

  • Oncology
  • Surgical Oncology
  • Gastroenterology

Background

  • Prognostic implications of peritoneal washing cytology (CY) in localized pancreatic ductal adenocarcinoma (PDAC) after preoperative chemoradiotherapy (CRT) are not well-defined.
  • Understanding the significance of positive CY status (CY+) is crucial for refining treatment strategies and patient counseling.

Purpose Of The Study

  • To determine the prognostic significance of CY+ in localized PDAC patients undergoing resection post-CRT.
  • To identify predictors associated with a positive CY status after preoperative CRT.

Main Methods

  • Retrospective analysis of clinical data from 141 localized PDAC patients who underwent curative-intent resection post-CRT.
  • Examination of the association between CY+ and clinicopathological factors, survival outcomes, and recurrence patterns.

Main Results

  • A positive CY status (CY+) was identified in 4.3% of patients.
  • CY+ patients showed higher CA19-9 levels, increased tumor location in the pancreatic body/tail, and greater anterior pancreatic capsule invasion.
  • CY+ was significantly linked to higher peritoneal recurrence rates (83.3% vs. 18.5%) and shorter overall survival (OS) and recurrence-free survival (RFS).

Conclusions

  • Peritoneal washing cytology is a valuable prognostic indicator in localized PDAC patients treated with preoperative CRT and resection.
  • CY+ independently predicts worse OS and RFS, underscoring its importance in risk stratification.
  • Factors like local invasion, poor histological response to CRT, and lack of adjuvant chemotherapy predict worse outcomes.