Role of Peritoneal Lavage Cytology and Prediction of Prognosis and Peritoneal Recurrence After Curative Surgery for Colorectal Cancer
Bae Sung-Joon, 신의섭, 기영준, 조상식, 문선미, 박선후,
소속 상세정보
( Bae Sung-Joon )
Korea Institute of Radiological & Medical Sciences Korea Cancer Center Hospital Department of Surgery
신의섭 ( Shin Ui-Sup )
Korea Institute of Radiological & Medical Sciences Korea Cancer Center Hospital Department of Surgery
기영준 ( Ki Young-Jun )
Korea Institute of Radiological & Medical Sciences Korea Cancer Center Hospital Department of Surgery
조상식 ( Cho Sang-Sik )
Korea Institute of Radiological & Medical Sciences Korea Cancer Center Hospital Department of Surgery
문선미 ( Moon Sun-Mi )
Korea Institute of Radiological & Medical Sciences Korea Cancer Center Hospital Department of Surgery
박선후 ( Park Sun-Hoo )
Korea Institute of Radiological & Medical Sciences Korea Cancer Center Hospital Department of Pathology
KMID : 0356720140300060266
Abstract
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.
키워드
Peritoneal metastasis; Cytology; Colorectal neoplasms; Survival; Prognosis
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