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Prognostic Value of Peritoneal Lavage Cytology in Patients with Pancreatic Ductal Adenocarcinoma Stratified by the Resectability Status

  • Original Article
  • Published:
Journal of Gastrointestinal Surgery

Abstract

Background

The prognostic value of peritoneal lavage cytology (CY) for pancreatic ductal adenocarcinoma (PDAC) remains controversial. We assessed the prognostic impact of CY status stratified by resectability in PDAC patients treated with surgical resection.

Methods

Clinical data from 440 patients with PDAC who underwent surgical resection were retrospectively analyzed to examine the association of CY status with clinicopathological factors and survival.

Results

Positive CY status (CY+) was found in 30 patients (7%). These patients had significantly worse overall survival in both the resectable (R) (P = 0.002) and borderline resectable (BR) (P < 0.001) groups. The median survival time of CY+ patients in the R and BR groups was 25.6 and 6.7 months, respectively. Multivariate analysis revealed that CY+ was an independent prognostic factor in the BR group (P < 0.001) but not in the R group (P = 0.08). In the R group, CY+ patients who received adjuvant chemotherapy had significantly longer overall survival than those without adjuvant chemotherapy (34.3 vs. 9.8 months, respectively; P < 0.001).

Conclusions

The prognosis of CY+ patients in the BR group was extremely poor. In the R group, surgical resection combined with adjuvant chemotherapy may improve the prognosis of CY+ patients.

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Acknowledgments

The authors would like to thank Enago (www.enago.jp) for the English language review.

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Authors and Affiliations

  1. Department of Surgery, Graduate School of Biomedical and Health Science, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan

    Takuya Sakoda, Kenichiro Uemura, Naru Kondo, Tatsuaki Sumiyoshi, Kenjiro Okada, Shingo Seo, Hiroyuki Otsuka & Shinya Takahashi

  2. Department of Advanced Medicine, Hiroshima University, Hiroshima, Japan

    Yoshiaki Murakami

Authors
  1. Takuya Sakoda
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  2. Kenichiro Uemura
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  3. Naru Kondo
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  4. Tatsuaki Sumiyoshi
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  5. Kenjiro Okada
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  6. Shingo Seo
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  7. Hiroyuki Otsuka
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  8. Yoshiaki Murakami
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  9. Shinya Takahashi
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Contributions

T Sakoda: conception, design, acquisition, analysis and interpretation of data, drafting the work; KU: design, interpretation of data, critical revision of the work; NK: conception, design, acquisition, interpretation of data, critical revision of the work; T Sumiyoshi: design, interpretation of data, critical revision of the work; KO: design, interpretation of data, critical revision of the work; SS: design, interpretation of data, critical revision of the work; HO: design, interpretation of data, critical revision of the work; YM: design, interpretation of data, critical revision of the work; ST: conception, design, interpretation of data, critical revision of the work. All authors approved the final manuscript and agree to be accountable for all aspects of the work.

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Correspondence to Kenichiro Uemura.

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Sakoda, T., Uemura, K., Kondo, N. et al. Prognostic Value of Peritoneal Lavage Cytology in Patients with Pancreatic Ductal Adenocarcinoma Stratified by the Resectability Status. J Gastrointest Surg 25, 2871–2880 (2021). https://doi.org/10.1007/s11605-021-04978-3

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