A Clinicopathological Study of Gastric Cancer with Peritoneal Lavage Cytology Positive without Peritoneal Dissemination

Daisuke Kobayashi, Ichiro Honda, Nobuyuki Kato, Kenji Tsuboi, Osamu Okouchi, Hidenobu Matsushita, Masashi Hattori, Yuko Takami and Ryoji Hashimoto

Department of Surgery, Tosei General Hospital

Introduction: We analyzed clinicopathological features and prognosis between patients with P0CY1 and P1. Methods: Intraoperative peritoneal lavage cytology was conducted in 339 patients undergoing gastric cancer surgery from 1996 to 2005. We found that ClassV cells in Papanicolaou's classification were positive for malignant cells (CY1). Results: There were 281 patients in P0, including 33 patients with CY1, and the incidence of CY1 was 11.7%. All with P0CY1 showed T3 or T4 invasion and lymph node metastasis, which were more advanced factors than that of those with P0CY0. The P0CY0 survivial was better than in P0CY1, and P0CY1 survival better than in P1. In dividing P1 into P1, P2 and P3 based on general rules for gastric cancer study, P0CY1 and P1 survival were better than in P3. We divided P0CY1 into two groups based on the number of free cancer cells in peritoneal lavage cytology. Survival in patients with a few cancer cells was better than that of those with many. In cases of P0CY1 undergoing gastrectomy and lymphadenectomy, the MST of group D2 was 497 days and that of group D0, D1 was 264 days, although this was not statistically significant. Conclusions: CY1 appeared to be a worse prognostic factor, but P0CY1 survival was better than in P1. Peritoneal lavage cytology for evaluating the number of free cancer cells may thus be a useful prognostic factor.

Key words
gastric cancer, peritoneal lavage cytology, peritoneal dissemination

Reprint requests
Daisuke Kobayashi Department of Surgery II, Graduate School and Faculty of Medicine, Nagoya University
65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550 JAPAN

Accepted
October 22, 2008

To read the PDF file you will need Abobe Reader installed on your computer.