Implications of peritoneal lavage cytology in resectable left-sided pancreatic cancer

Surg Today. 2015 Apr;45(4):444-50. doi: 10.1007/s00595-014-0964-7. Epub 2014 Jul 1.

Abstract

Purpose: The aim of this study was to determine the utility of the peritoneal lavage cytology findings in predicting the clinical outcomes of resectable left-sided pancreatic cancer.

Methods: Peritoneal lavage samples were collected from 39 consecutive patients who underwent surgery for left-sided pancreatic cancer between January 2000 and December 2010. We analyzed the correlations between the peritoneal lavage cytology findings and the clinical outcomes.

Results: Five patients (12.8 %) had malignant cells in the cytology samples (positive cytology). This occurred more frequently in patients with vascular invasion (P = 0.008). Positive cytology was significantly associated with lower overall (P = 0.0007) and recurrent-free (P < 0.0001) survival rates. Positive cytology was an independent prognostic factor for recurrence (P = 0.022); it was closely associated with local recurrence, peritoneal recurrence and distant metastasis.

Conclusion: Surgeons should carefully consider the intraoperative diagnosis of peritoneal lavage cytology in patients with resectable left-sided pancreatic cancers, because patients with positive cytology are likely to experience recurrence.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Carcinoma, Pancreatic Ductal / diagnosis*
  • Carcinoma, Pancreatic Ductal / mortality
  • Carcinoma, Pancreatic Ductal / pathology
  • Carcinoma, Pancreatic Ductal / surgery
  • Cohort Studies
  • Cytodiagnosis / methods*
  • Disease-Free Survival
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Pancreatectomy / methods
  • Pancreatic Neoplasms / diagnosis*
  • Pancreatic Neoplasms / mortality
  • Pancreatic Neoplasms / pathology
  • Pancreatic Neoplasms / surgery
  • Peritoneal Lavage / methods*
  • Predictive Value of Tests
  • Retrospective Studies
  • Treatment Outcome