Evaluation of Peritoneal Lavage Cytology in castric Cancer Operation

Akira Tanaka, kiyotaka Okuno, Ichizou Nakajima, Tsutomu Watanabe, Yoshinori Fujii, Yasuaki Sirayama, Masayuki Yasutomi

First Department of Surgery, Kinki University School of Medicine

Intraoperative peritoneal lavage cytology was performed in 682 patients with gastric cancer to determine the relationship between positive cytology, pathological findings of gastric cancer and prognostic value of positive cytology. The rate of occurrence of free cancer cells was 11.1% in the total 682 cases, 7.2% in resected cases and 2.7% in cases of curative resection. In terms of serosal invasion, the incidence of positive lavage cytology was 14.8% in S₂ and 28.2% in S₃. In terms of depth of wall invasion, it was null in m and sm, 0.9% in ps (-) and 15.2% in ps (+). By macroscopic type, types 3 and 4 of Borrmann's classification, the poorly differentiated type and INFγ showed intraperitoneal free cancer cells, and 22.5% in stage IV showed a significantly higher rate. In cases of positive lavagecytology, even if cancer was resected curatively, all patients except one who survived more than 10 years had died as a result of peritoneal dissemination within 3 years after operation. The 2 year survival rate of 24.2% for these patients was not significantly difference from the 8.5% rate for those with peritoneal dessemination.

Key words
peritoneal lavage cytology, intraperitoneal free cancer cell, prognosis of gastric cancer

Reprint requests
Akira Tanaka First Department of Surgery, Kinki University School of Medicine
337-2 Ono-Higashi, OSaka-Sayama, 589 JAPAN

Accepted
September 4, 1991

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