Evaluation of Peritoneal Lavage Cytology in patients with Advanced Colorectal Cancer

Jiro Nasu, Kenjiro Kotake, Yasuo Koyama, Hideaki Shimizu, Shoichi Hishinuma, Takao Inada, Junichi Matsui, Iwao Ozawa, Jiro Ando, Yoshiro Ogata

Department of Surgery, Tochigi Cancer Center

To evaluate the efficacy of identification of free cancer cells in the peritoneal cavity for predicting peritoneal recurrence after curative surgery, 188 patients with primary advanced colorectal cancer were studied using intra-operative peritoneal lavage cytology. The rates of positive cytology in patients with and without macroscopic peritoneal dissemination were 53.3% (8/15) and 5.8% (10/173), respectively (p<0.01). Of the latter, 3 had carcinoma invading to the subserosal layer and 7 beyond the serosal surface, 8 had differentiated adenocarcinoma and 2 had mucinous carcinoma. Of the 10 patients who had positive cytology without macroscopic peritoneal dissemination, peritoneal recurrence was observed in 4 (40%), while of the 163 with negative cytology, it occurred in 3 (1.8%). The 5-year survival rates of patients with and without positive cytology were 48% and 83%, respectively (p<0.01). In conclusion, this study suggests that peritoneal lavage cytology may be a useful diagnostic procedure to predict peritoneal recurrence in advanced colorectal cancer.

Key words
colorectal cancer, cytology, peritoneal dissemination, peritoneal recurrence

Reprint requests
Jiro Nasu Department of Surgery, Tochigi Cancer Center
4-9-13 Yohnan, Utsunomiya, 320 JAPAN

Accepted
June 14, 1995

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