Role of Peritoneal Lavage Cytology and Prediction of Prognosis and Peritoneal Recurrence After Curative Surgery for Colorectal Cancer

被引:10
作者
Bae, Sung Joon [1 ]
Shin, Ui Sup [1 ]
Ki, Young-Jun [1 ]
Cho, Sang Sik [1 ]
Moon, Sun Mi [1 ]
Park, Sun Hoo [2 ]
机构
[1] Korea Canc Ctr Hosp, Korea Inst Radiol & Med Sci, Dept Surg, 75 Nowon Ro, Seoul 139706, South Korea
[2] Korea Canc Ctr Hosp, Korea Inst Radiol & Med Sci, Dept Pathol, Seoul, South Korea
关键词
Peritoneal metastasis; Cytology; Colorectal neoplasms; Survival; Prognosis;
D O I
10.3393/ac.2014.30.6.266
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
Purpose: In colorectal cancer, the role of detecting free malignant cells from peritoneal lavage is currently unclear. In this study, we investigated the positive rate of free malignant cells in peritoneal lavage fluid and their predictive value for prognosis and peritoneal recurrence after a curative resection. Methods: From October 2009 to December 2011, in a prospective manner, we performed cytologic examinations of peritoneal lavage fluid obtained just after the abdominal incision from 145 patients who underwent curative surgery for colorectal cancer. We used proportional hazard regression models to analyze the predictive role of positive cytology for peritoneal recurrence and survival. Results: Among total 145 patients, six patients (4.1%) showed positive cytology. During the median follow-up of 32 months (range, 8-49 months), 27 patients (18.6%) developed recurrence. Among them, 5 patients (3.4%) showed peritoneal carcinomatosis. In the multivariate analysis, positive cytology was an independent predictive factor for peritoneal recurrence (hazard ratio [HR], 136.5; 95% confidence interval [CI], 12.2-1,531.9; P < 0.0001) and an independent poor prognostic factor for overall survival (HR, 11.4; 95% CI, 1.8-72.0; P = 0.009) and for disease-free survival (HR, 11.1; 95% CI, 3.4-35.8; P < 0.0001). Conclusion: Positive cytology of peritoneal fluid was significantly associated with peritoneal recurrence and worse survival in patients undergoing curative surgery for colorectal cancer. Peritoneal cytology might be a useful tool for selecting patients who need intraperitoneal or systemic chemotherapy.
引用
收藏
页码:266 / 273
页数:8
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