Skip to main content

Advertisement

SpringerLink
Log in

Free Colorectal Cancer Cells on the Peritoneal Surface: Correlation With Pathologic Variables and Survival

  • Original Contributions
  • Published:
Diseases of the Colon & Rectum

BACKGROUND

Clinicopathologic staging of colorectal cancer remains the best predictor of survival. Prognostication for an individual with colorectal cancer remains elusive. This study was designed to investigate the incidence of free surface colorectal cancer cells detected by cytology during elective open curative resection, to correlate their presence with particular clinicopathologic variables and determine whether their presence was predictive of cancer-specific survival.

METHODS

Over a six-year period in one institution, all elective colon and intraperitoneal rectal cancer specimens were assessed during primary resection for the presence of free colorectal cancer cells by means of a simple and tested specimen imprint cytology methodology. Clinicopathologic variables were assessed prospectively and blinded to cytology results. All patients were followed up routinely until death and if the patient was not seen within the last six months, information was obtained from the New South Wales Registry of Births, Deaths and Marriages in Australia.

RESULTS

Overall, 26 of 281 (9.25 percent) colorectal cancers had positive cytology for cancer cells on the peritoneal surface of the bowel. Poorly differentiated tumors were significantly associated with positive cytology. Tumor penetration, presence of vascular or neural invasion, mucinous characteristics, lymph node status, and operative procedure performed were not statistically significant predictors of positive cytology. Overall, 43 of the 281 patients (15.3 percent) died during the mean follow-up period of 49.2 months from cancer-related deaths. Of these patients, 8 had positive cytology and 35 had negative cytology results. Cancer-specific survival assessed with the log-rank test was significantly associated with positive cytology in univariate (P = 0.008) and multivariate analysis (P < 0.001).

CONCLUSION

In this study, the presence of free surface colorectal cancer cells has been shown to be predictive of survival and is independent of direct peritoneal invasion and lymph node status. Thus, further assessment of this simple prognostic variable is warranted and selection of patients with positive cytology for possible adjuvant therapies may be beneficial.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1.

Similar content being viewed by others

REFERENCES

  1. D Skipper AJ Cooper JE Marston I Taylor (1987) ArticleTitleExfoliate cells and in vitro growth in colorectal cancer Br J Surg 74 1049–52 Occurrence Handle1:STN:280:BieD2sfovFY%3D Occurrence Handle3690235

    CAS  PubMed  Google Scholar 

  2. GD Willet (1985) ArticleTitlePrognostic value of cytologic peritoneal washings Clin Lab Med 5 265–74 Occurrence Handle3896625

    PubMed  Google Scholar 

  3. EM Ziselman SE Harkavy M Hogan W West B Atkinson (1984) ArticleTitlePeritoneal washing cytology. Uses and diagnostic criteria in gynecologic neoplasms Acta Cytol 28 105–10 Occurrence Handle1:STN:280:BiuC2cblt1I%3D Occurrence Handle6583966

    CAS  PubMed  Google Scholar 

  4. PD Murphy V Wadhera SM Griffin et al. (1993) ArticleTitleFree peritoneal tumor cell identification in patients with gastric and colorectal cancer J R Coll Surg Edinb 38 28–32 Occurrence Handle1:STN:280:ByyC2s3hvFY%3D Occurrence Handle7679740

    CAS  PubMed  Google Scholar 

  5. JJ Bonenkamp I Songun J Hermans CJ Velde Particlevan de (1996) ArticleTitlePrognostic value of positive cytology findings from abdominal washings in patients with gastric cancer Br J Surg 83 672–4 Occurrence Handle1:STN:280:BymB1MnisFU%3D Occurrence Handle8689216

    CAS  PubMed  Google Scholar 

  6. A Schott I Vogel U Krueger et al. (1998) ArticleTitleIsolated tumor cells are frequently detectable in the peritoneal cavity of gastric and colorectal cancer patients and serve as a new prognostic marker Ann Surg 227 372–9 Occurrence Handle10.1097/00000658-199803000-00009 Occurrence Handle1:STN:280:DyaK1c7os1aruw%3D%3D Occurrence Handle9527060

    Article  CAS  PubMed  Google Scholar 

  7. MJ Solomon M Egan RA Roberts J Philips P Russell (1997) ArticleTitleIncidence of free colorectal cancer cells on the peritoneal surface Dis Colon Rectum 40 1294–8 Occurrence Handle1:STN:280:DyaK1c%2FjsVSgtw%3D%3D Occurrence Handle9369102

    CAS  PubMed  Google Scholar 

  8. AJ Leather G Kocjan F Savage et al. (1994) ArticleTitleDetection of free malignant cells in the peritoneal cavity before and after resection of colorectal cancer Dis Colon Rectum 37 814–9 Occurrence Handle1:STN:280:ByuA3szgvVc%3D Occurrence Handle8055727

    CAS  PubMed  Google Scholar 

  9. NS Ambrose F Macdonald J Young H Thompson MR Keighley (1989) ArticleTitleMonoclonal antibody and cytological detection of free malignant cells in the peritoneal cavity during resection of colorectal cancer – can monoclonal antibodies do better? Eur J Surg Oncol 15 99–102 Occurrence Handle1:STN:280:BiaC1MnntFA%3D Occurrence Handle2649397

    CAS  PubMed  Google Scholar 

  10. SH Quan (1959) ArticleTitleCul-de-sac smears for cancer cells Surgery 45 258–63 Occurrence Handle1:STN:280:CyaD2MvlsVM%3D Occurrence Handle13625001

    CAS  PubMed  Google Scholar 

  11. LS Wong WJ Bateman AG Morris IA Fraser (1995) ArticleTitleDetection of circulating tumour cells with the magnetic activated cell sorter Br J Surg 82 1333–7 Occurrence Handle1:STN:280:BymD1MjotFI%3D Occurrence Handle7489156

    CAS  PubMed  Google Scholar 

  12. MC Horattas MR Evasovich N Topham (1997) ArticleTitleColorectal carcinoma and the relationship of peritoneal cytology Am J Surg 174 334–7 Occurrence Handle10.1016/S0002-9610(97)00111-6 Occurrence Handle1:STN:280:ByiH28vjt1w%3D Occurrence Handle9324149

    Article  CAS  PubMed  Google Scholar 

  13. T Boku Y Nakane T Minoura et al. (1990) ArticleTitlePrognostic significance of serosal invasion and free intraperitoneal cancer cells in gastric cancer Br J Surg 77 436–9 Occurrence Handle1:STN:280:By%2BB2MvjvFY%3D Occurrence Handle2340396

    CAS  PubMed  Google Scholar 

  14. P Vogel J Ruschoff S Kummel et al. (2000) ArticleTitlePrognostic value of microscopic peritoneal dissemination: comparison between colon and gastric cancer Dis Colon Rectum 43 92–100 Occurrence Handle1:STN:280:DC%2BD3c3ntFagug%3D%3D Occurrence Handle10813130

    CAS  PubMed  Google Scholar 

  15. WT Hatzidis MJ Solomon M Schnitzler J Cartmill P Loder P Chapuis (2000) ArticleTitleDoes the caseload of the pathologist influence the minimum and extended data set of pathology variables reported for rectal adenocarcinoma? Colorect Dis 2 26–30 Occurrence Handle10.1046/j.1463-1318.2000.00081.x

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Colorectal Surgery and Surgical Outcomes, Research Center, Royal Prince Alfred Hospital, Sydney, Australia

    Sriskanthan Baskaranathan M.B., B.Ch., Pauline McCredden R.N., Grad. Cert. S.T.N.,  & Michael J. Solomon M.B., B.Ch. (Hons), M.Sc. , F.R.A.C.S.

  2. Department of Anatomic Pathology, Royal North Shore Hospital, Sydney, Australia

    Jeanette Philips M.B., B.Ch., F.R.C.P.A, F.I.A.C.

  3. University of Sydney, Sydney, Australia

    Jeanette Philips M.B., B.Ch., F.R.C.P.A, F.I.A.C.  & Michael J. Solomon M.B., B.Ch. (Hons), M.Sc. , F.R.A.C.S.

Authors
  1. Sriskanthan Baskaranathan M.B., B.Ch.
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Jeanette Philips M.B., B.Ch., F.R.C.P.A, F.I.A.C.
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Pauline McCredden R.N., Grad. Cert. S.T.N.,
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Michael J. Solomon M.B., B.Ch. (Hons), M.Sc. , F.R.A.C.S.
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Michael J. Solomon M.B., B.Ch. (Hons), M.Sc. , F.R.A.C.S..

Additional information

Reprints are not available.

About this article

Cite this article

Baskaranathan, S., Philips, J., McCredden, P. et al. Free Colorectal Cancer Cells on the Peritoneal Surface: Correlation With Pathologic Variables and Survival. Dis Colon Rectum 47, 2076–2079 (2004). https://doi.org/10.1007/s10350-004-0723-8

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10350-004-0723-8

Key words

Search

Navigation