The prognostic impact of peritoneal washing cytology for otherwise resectable extrahepatic cholangiocarcinoma patients

Surg Today. 2021 Jul;51(7):1227-1231. doi: 10.1007/s00595-020-02208-y. Epub 2021 Jan 20.

Abstract

The clinical importance of peritoneal washing cytology (PWC) for cholangiocarcinoma patients remains unclear. The clinical data of 137 extrahepatic cholangiocarcinoma patients who received PWC and curative surgery were retrospectively analyzed. Among the 137 patients analyzed, five (3.6%) had positive PWC, and 132 (96.4%) had negative PWC. The median survival time in patients with negative PWC was 6.45 years, and the overall 1-, 2-, and 5-year survival rates were 86.5%, 75.3%, and 51.6%, respectively. The median survival time in patients with positive PWC was 2.56 years, and the overall 1-, 2-, and 5-year survival rates were 60.0%, 60.0%, and 40.0%, respectively. A multivariate analysis revealed that positive lymph node metastasis (P < 0.001), positive perineural invasion (P = 0.014) and no use of adjuvant chemotherapy (P < 0.001), but not positive PWC were independently associated with a worse overall survival. In conclusion, surgery and subsequent chemotherapy might be a therapeutic option for cholangiocarcinoma patients with positive PWC.

Keywords: Extrahepatic cholangiocarcinoma; Peritoneal washing cytology; Surgery.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Bile Duct Neoplasms / diagnosis*
  • Bile Duct Neoplasms / drug therapy
  • Bile Duct Neoplasms / mortality*
  • Bile Duct Neoplasms / surgery
  • Cholangiocarcinoma / diagnosis*
  • Cholangiocarcinoma / drug therapy
  • Cholangiocarcinoma / mortality*
  • Cholangiocarcinoma / surgery
  • Cytodiagnosis / methods*
  • Female
  • Humans
  • Lymphatic Metastasis
  • Male
  • Middle Aged
  • Peritoneal Lavage*
  • Prognosis
  • Retrospective Studies
  • Survival Rate
  • Young Adult