Peritoneal Lavage Cytology in Gastric Cancer Operation -A Study on the Prognostic Value using Multivariate Analysis-

Keiichi Fujino*, Takashi Ichikura, Kazuo Hase*, Soichi Tomimatsu, Kazuhiko Uefuji, Shoetsu Tamakuma

First Department of Surgery, National Defense Medical College
*Department of Surgery, Self Defense Force Central Hospital

Intraoperative peritoneal lavage cytology was performed in 201 patients with gastric cancer to determine the relationship between positive cytology, pathological findings, and prognosis. The incidence of positive cytology was 17.9% and increased in parallel with cancer progression. In patients with macroscopic serosal invasion the incidence of positive lavage cytology was 0% in S0 and S1, but 38.7% in S2 and S3. The patients in whom the diameter of cancer invasion in the subserosal layer was 4 cm or more had a higher rate (38.994) than those with a diameter less than 4 cm (10.5%). Patients with infiltrative type γ (INFγ) had a higher incidence of positive cytology. Results according to depth of invasion showed that survival rates in patients with positive lavage cytology were lower than those with negative lavage cytology. Also the patients with positive lavage cytology and a higher recurrence rare, especially peritoneal recurrence. Prognostic factors were determined in 88 patients with curative gastrectomy for advanced cancer by multivariate analysis using Cox's proportional hazard model. The nodal stage (p=0.008) and the peritoneal lavage cytology (p=0.023) together with depth of invasion were independent prognostic factors. The peritoneal lavage cytology can be an independent predictor for future peritoneal dissemination and prognosis.

Key words
gastric cancer, peritoneal lavage cytology, prognosis of gastric cancer

Reprint requests
Keiichi Fujino First Department of Surgery, National Defense Medical College
3-2 Namiki, Tokorozawa, 359 JAPAN

Accepted
April 3, 1996

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