Evaluation of lntraoperative Peritoneal Lavage Cytology in Gastric Cancer

Atsushi Yamamoto, Hirohiko Akiyama, Kazuteru Tanabe, Katsuhiko Shimizu, Kazuhito Minami, Shuji Saeki, Hidenori Mukaida, Kazufumi Hisamatsu, Akira Kameda, Shigeru Iwamori

Department of Surgey, Hiroshima City Asa Hospital

Intraoperative peritoneal lavage cytology was performed in 165 patients with gastric cancer. We determined that Class IV and Class V cells in Papanicolaou's classification were positive for malignant cells [cy(+)] and that Class I-Class III were negative [cy(-)] . The incidence of cy(+) was 24.8% among all patients. The 50% survival times of patients that had peritoneal dissemination [P(+)] and were cy(+) was 5.5 months. The 50% survival times of patients without peritoneal dissemination [P(-)] and who were cy(+), who were P(+) and cy(-), who were P(-) and cy(-), and whose lesions were non-resectable were 11.9, 22.0, 25.5, and 3.7 months, respectively. The 3-year cumulative survival rate of the P(-)cv(+) patients was higher (9.1%) than that of the P(+)cy(+) patients and "non-resectable" patients, but significantly lower than that of the P(-)cy(-) and P(+)cy(-) patients (p<0.05). There were 11 P(-)cy(+) patients, 9 of whom died of gastric cancer. Peritoneal dissemination was found in five of the nine patients. This suggests that P is not a suitable prognostic factor, and that the cytology of intraoperative peritoneal lavage fluid is more important.

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

Reprint requests
Atsushi Yamamoto Department of Surgery, Hiroshima City Asa Hospital
2-1-1 Kabeminami, Asakita-ku, Hiroshima, 731-02 JAPAN

Accepted
July 2, 1997

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