Reappraisal of Peritoneal Washing Cytology in 984 Patients with Pancreatic Ductal Adenocarcinoma Who Underwent Margin-Negative Resection
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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.
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.
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.
KeywordsPancreatic ductal adenocarcinoma Peritoneal washing cytology Peritoneal carcinomatosis Survival analysis Adjuvant chemotherapy
Conflict of Interest
The authors have no conflicts of interest to disclose.
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