Evaluation of Peritoneal Lavage Cytology in Gastric Cancer Operation -A Study on the Prognostic Significance Analyzed by Cox Proportional Hazard Model-

Etsuro Bando, Yasuo Takeshita, Katsuhiro Yoshimoro, Go Minatoya, Yutaka Yoshimitsu, Yoshiaki Isobe

Department of Surgery, Maizuru Kyousai Hospital

Cytological examintion of lavaged peritoneal fluid taken from 557 gastric cancer patients was performed to determine the relationship between positive cytology, reveral clinicopathologic parameters, and prognosis. The incidence of positive cytology was 13.6%, and no positive cytological findings were revealed in the groups in which tumor invasion was confined to the mucosa, submucosa, or the muscularis propria. The rates of positive cytology in patients in which depth of invasion was subserosa, serosaexposed, and serosa-infiltrating were 11.8%, 29.8%, and 45.0%, respectively. The prognosis of the patients, having no peritoneal metastasis, but with positive cytology, was significantly poorer than that of the patients with grade P₁ dissemination (p=0.017). Prognostic factors were determined in 288 patients with advanced gastric cancer by multivariate analysis using Cox's proportional hazard mode. The tumor invasion was the strongest prognostic variable (p<0.001), and the peritoneal cytological examination (p=0.012). Peritoneal lavage cytology was judged to be an independent prognostic factor. The patients with positive lavage cytology had a significantly higher rate of recurrence in the peritoneum (p<0.001). The se results indicate that peritoneal lavage cytology may be a positive method in determining the potential of the recurrence in the peritoneum, or the prognosis of patients with gastric cancer.

Key words
gastric cancer, peritoneal lavage cytology, peritoneal recurrence, prognostic factor of gastric cancer

Reprint requests
Etsuro Bando Second Department of Surgery, School of Medicine, Kanazawa University
13-1 Takara-machi, Kanazawa, Ishikawa 920-0934 JAPAN

Accepted
December 3, 1997

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