Scoring system to predict positive peritoneal cytology in patients with resectable and borderline resectable pancreatic cancer

J Hepatobiliary Pancreat Sci. 2024 Jul;31(7):492-502. doi: 10.1002/jhbp.1436. Epub 2024 May 12.

Abstract

Background: The aim of this study was to evaluate factors to predict positive peritoneal cytology, whcih would determine the indication for staging laparoscopy in pancreatic cancer.

Methods: A total of 430 patients that underwent pancreatectomy for resectable and borderline resectable pancreatic cancer were retrospectively reviewed.

Results: Among 430 patients, 36 had positive cytology (8.4%). Median survival time in negative cytology was 24.7 months, compared with 15.1 months in positive cytology (p = .004). Factors to predict positive cytology in pancreatic cancer according to multivariate analysis were tumor location (body, tail; OR 2.66; 95% CI: 1.21-5.85; p = .015), tumor size ≥30 mm (OR 2.95; 95% CI: 1.35-6.47; p = .007) and radiographic other-organ invasion (HR 2.79; 95% CI: 1.01-7.67; p = .047). Patients were scored 0 to 3 corresponding with these factors. Rates of positive cytology increases in each score were: score 0: 2.9%, score 1: 6.7%, score 2: 18.3%, score 3: 36.8%.

Conclusions: Tumor location (body or tail), tumor size ≥30 mm, and radiographic other-organ invasions were risk factors for positive cytology in pancreatic cancer. This scoring system might be a useful indicator to perform staging laparoscopy to diagnose positive cytology.

Keywords: cytology; pancreatic cancer; risk factor; scoring system; staging laparoscopy.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Cytodiagnosis / methods
  • Female
  • Humans
  • Laparoscopy / methods
  • Male
  • Middle Aged
  • Neoplasm Invasiveness / pathology
  • Neoplasm Staging*
  • Pancreatectomy* / methods
  • Pancreatic Neoplasms* / diagnostic imaging
  • Pancreatic Neoplasms* / mortality
  • Pancreatic Neoplasms* / pathology
  • Pancreatic Neoplasms* / surgery
  • Peritoneal Neoplasms / mortality
  • Peritoneal Neoplasms / pathology
  • Peritoneal Neoplasms / surgery
  • Predictive Value of Tests
  • Prognosis
  • Retrospective Studies
  • Survival Rate