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Lavage cytology diagnosed by immunostaining may be a poor prognostic factor in pathological stage III colorectal cancer

  • 0Division of Colon and Rectal Surgery Shizuoka Cancer Center Hospital Shizuoka Japan.
Annals of Gastroenterological Surgery +

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March 6, 2025

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March 6, 2025

View abstract on PubMed

Summary

This summary is machine-generated.

Positive intraoperative lavage cytology (LCY) in stage III colorectal cancer (CRC) patients indicates a poorer prognosis. Immunostaining for LCY is a significant predictor of reduced overall survival and relapse-free survival after surgery.

Area Of Science

  • Oncology
  • Surgical Oncology
  • Gastroenterology

Background

  • Colorectal cancer (CRC) remains a significant health concern globally.
  • Accurate prognostic markers are crucial for tailoring treatment strategies in pathological stage III CRC.
  • Intraoperative lavage cytology (LCY) is increasingly explored as a potential prognostic indicator.

Purpose Of The Study

  • To evaluate the prognostic impact of positive lavage cytology (LCY) diagnosed by immunostaining.
  • To assess the association between positive LCY and long-term outcomes in patients with pathological stage III CRC undergoing curative resection.

Main Methods

  • Retrospective analysis of 708 patients with pathological stage III CRC who underwent radical resection and intraoperative LCY.
  • LCY specimens evaluated using Papanicolaou staining and immunostaining (CEA, Ber-EP4).
  • Patients classified into positive LCY (LCY+) and negative LCY (LCY-) groups; overall survival (OS) and relapse-free survival (RFS) compared.

Main Results

  • Positive LCY was observed in 4.2% of patients (30/708).
  • The LCY+ group showed significantly lower 5-year OS (58.7% vs. 91.0%) and RFS (28.8% vs. 76.6%) compared to the LCY- group.
  • Multivariate analysis confirmed positive LCY as an independent predictor of poorer OS and RFS.

Conclusions

  • Positive intraoperative lavage cytology, particularly when diagnosed by immunostaining, is a significant poor prognostic factor in pathological stage III CRC.
  • Immunostaining may detect positive LCY even when Papanicolaou staining is negative, without altering the prognostic significance.

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