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Journal of Gastrointestinal Surgery

, Volume 19, Issue 1, pp 6–14 | Cite as

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

  • Sohei Satoi
  • Yoshiaki MurakamiEmail author
  • 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 Fukumoto
  • A-Hon Kwon
2014 SSAT Plenary Presentation

Abstract

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.

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.

Keywords

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

Notes

Conflict of Interest

The authors have no conflicts of interest to disclose.

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Copyright information

© The Society for Surgery of the Alimentary Tract 2014

Authors and Affiliations

  • Sohei Satoi
    • 1
  • Yoshiaki Murakami
    • 2
    Email author
  • Fuyuhiko Motoi
    • 3
  • Kenichiro Uemura
    • 2
  • Manabu Kawai
    • 4
  • Masanao Kurata
    • 5
  • Masayuki Sho
    • 6
  • Ippei Matsumoto
    • 7
  • Hiroaki Yanagimoto
    • 1
  • Tomohisa Yamamoto
    • 1
  • Masamichi Mizuma
    • 3
  • Michiaki Unno
    • 3
  • Yasushi Hashimoto
    • 2
  • Seiko Hirono
    • 4
  • Hiroki Yamaue
    • 4
  • Goro Honda
    • 5
  • Minako Nagai
    • 6
  • Yoshiyuki Nakajima
    • 6
  • Makoto Shinzeki
    • 7
  • Takumi Fukumoto
    • 7
  • A-Hon Kwon
    • 1
  1. 1.Department of SurgeryKansai Medical UniversityOsakaJapan
  2. 2.Department of Surgery, Institute of Biomedical and Health SciencesHiroshima UniversityHiroshimaJapan
  3. 3.Division of Gastroenterological Surgery, Department of SurgeryTohoku UniversitySendaiJapan
  4. 4.Second Department of SurgeryWakayama Medical UniversityWakayamaJapan
  5. 5.Department of SurgeryTokyo Metropolitan Cancer and Infectious Diseases Center Komagome HospitalTokyoJapan
  6. 6.Department of SurgeryNara Medical UniversityNaraJapan
  7. 7.Division of Hepato-Biliary-Pancreatic Surgery, Department of SurgeryKobe University Graduate School of MedicineKobeJapan

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