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Comparison of prognostic impact between positive intraoperative peritoneal and lavage cytologies in colorectal cancer

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Abstract

Background

The prognostic value of positive intraoperative peritoneal cytology and lavage cytology, including the differences in their prognostic impact, in colorectal cancer is controversial. We aimed to investigate the prognostic values of positive peritoneal cytology and lavage cytology findings for colorectal cancer and compare their prognostic impact.

Methods

We retrospectively evaluated 592 clinical stage II–IV colorectal cancer patients who underwent peritoneal cytology (n = 225) or lavage cytology (n = 367) between November 1993 and December 2018. The prognostic factors for cancer-specific survival were identified, and the differences in cancer-specific survival were examined between the patients.

Results

The cytology-positive rate was 10.8% (64/592), 17.8% (40/225), and 6.5% (24/367) in the overall, peritoneal cytology, and lavage cytology groups, respectively. Both positive peritoneal cytology (hazard ratio: 2.196) and lavage cytology (hazard ratio: 2.319) were independent prognostic factors. The peritoneal cytology-positive group showed significantly poorer cancer-specific survival than the cytology-negative group (5-year: 3.5% vs. 59.5%; 10-year: 3.5% vs. 46.1%, p < 0.001). Similar results were obtained for lavage cytology (5-year: 14.1% vs. 73.9%; 10-year: 4.7% vs. 63.5%, p < 0.001). The cancer-specific survival was not significantly different between the peritoneal cytology-positive and lavage cytology-positive groups (p = 0.058). Both positive peritoneal and lavage cytology were associated with poorer cancer-specific survival across all colorectal cancer stages.

Conclusions

Positive peritoneal and lavage cytology are associated with worse cancer-specific survival in colorectal cancer. The prognostic impact was comparable between positive lavage and peritoneal cytology. Thus, cytology should be a standard assessment modality for colorectal cancer.

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Acknowledgements

The authors thank Dr. Norihiko Shimoyama, Satoru Munakata, and Hanae Kushibiki for establishing the cytology findings.

Funding

This study did not receive any funding.

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Author notes

  1. Kentaro Sato and Ken Imaizumi contributed equally to this work.

Authors and Affiliations

  1. Department of Gastroenterological Surgery, Hakodate Municipal Hospital, 1-10-1 Minatocho, Hakodate, Hokkaido, 041-8680, Japan

    Kentaro Sato, Ken Imaizumi, Hiroyuki Kasajima, Michihiro Kurushima, Minoru Umehara, Yosuke Tsuruga, Daisuke Yamana, Keisuke Obuchi, Aya Sato & Kazuaki Nakanishi

Authors
  1. Kentaro Sato
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  2. Ken Imaizumi
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  3. Hiroyuki Kasajima
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  4. Michihiro Kurushima
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  5. Minoru Umehara
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  6. Yosuke Tsuruga
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  7. Daisuke Yamana
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  9. Aya Sato
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  10. Kazuaki Nakanishi
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Contributions

Conceptualization: KS, KI, HK, MK, MU, YT, DY, KO, AS, and KN; methodology: KS, KI, and HK; formal analysis and investigation: KS and KI; writing—original draft preparation: KS and KI; writing—review and editing: KS and KI; funding acquisition: not applicable; resources: not applicable; supervision: KN.

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Correspondence to Ken Imaizumi.

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Sato, K., Imaizumi, K., Kasajima, H. et al. Comparison of prognostic impact between positive intraoperative peritoneal and lavage cytologies in colorectal cancer. Int J Clin Oncol 26, 1272–1284 (2021). https://doi.org/10.1007/s10147-021-01918-8

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  • DOI: https://doi.org/10.1007/s10147-021-01918-8

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