Revisiting the prognostic significance of positive peritoneal cytology in pancreatic cancer.

177 Background: Positive peritoneal cytology (PPC) in the setting of pancreatic cancer predicts a poor prognosis, such that it is considered metastatic disease in the American Joint Commission on Cancer staging guidelines. We re-evaluate the role of PPC, with particular attention to outcomes following neoadjuvant therapy. Methods: We retrospectively identified 185 patients from January 1, 2000 to present with the diagnosis of pancreatic adenocarcinoma who had undergone peritoneal washings with cytology at the time of planned resection. Data regarding demographics, tumor stage, intraoperative cytology, surgical and chemoradiation therapeutics, and clinicopathological outcomes were analyzed, with the primary endpoints being disease-free and overall survival (DFS and OS). Results: 20 patients (11%) had PPC at the time of planned resection; of these, 11 patients (55%) received neoadjuvant therapy prior to surgery. 165 patients (89%) had negative peritoneal cytology (NPC) at the time of planned resection; of these, 75 (45%) received neoadjuvant therapy prior to surgery. All patients proceeded with resection in the absence of visible metastatic disease. 42% of NPC reached 2-year survival compared to just 20% of patients with PPC. Overall, patients with PPC vs. NPC had significantly poorer DFS (p<0.0064) and OS (p<0.0135). When stratifying by neoadjuvant therapy, in those patients with stage II disease or higher who did not receive neoadjuvant therapy, multivariable CART analysis revealed that PPC predicted poorer DFS compared with NPC (p<0.004). However, among stage II or higher disease receiving neoadjuvant therapy, it failed to show a significant difference in DFS or OS between PPC and NPC. Conclusions: Overall, patients with positive peritoneal cytology are shown to have worse DFS and OS compared to patients with negative peritoneal cytology in pancreatic adenocarcinoma. However, after multivariable analysis, the prognostic significance of positive peritoneal cytology disappears in those patients with stage II and higher disease receiving neoadjuvant therapy.

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Prognostic significance of peritoneal cytology in low-risk endometrial cancer: comparison of laparoscopic surgery and laparotomy

International Journal of Clinical Oncology ◽

10.1007/s10147-020-01854-z ◽

2021 ◽

Author(s):

Satoe Fujiwara ◽

Ruri Nishie ◽

Shoko Ueda ◽

Syunsuke Miyamoto ◽

Shinichi Terada ◽

...

Keyword(s):

Endometrial Cancer ◽

Laparoscopic Surgery ◽

Retrospective Study ◽

Prognostic Significance ◽

Low Risk ◽

Peritoneal Cytology ◽

Chi Square ◽

Significant Difference ◽

Chi Square Test ◽

Positive Peritoneal Cytology

Abstract Background There is uncertainty surrounding the prognostic value of peritoneal cytology in low-risk endometrial cancer, especially in laparoscopic surgery. The objective of this retrospective study is to determine the prognostic significance of positive peritoneal cytology among patients with low-risk endometrial cancer and to compare it between laparoscopic surgery and conventional laparotomy. Methods From August 2008 to December 2019, all cases of pathologically confirmed stage IA grade 1 or 2 endometrial cancer were reviewed at Osaka Medical College. Statistical analyses used the Chi-square test and the Kaplan–Meier log rank. Results A total of 478 patients were identified: 438 with negative peritoneal cytology (232 who underwent laparotomy and 206 who undertook laparoscopic surgery) and 40 with positive peritoneal cytology (20 who underwent laparotomy and 20 who received laparoscopic surgery). Survival was significantly worse among patients with positive peritoneal cytology compared to patients with negative peritoneal cytology. However, there was no significant difference among patients with negative or positive peritoneal cytology between laparoscopic surgery and laparotomy. Conclusion This retrospective study suggests that, while peritoneal cytology is an independent risk factor in patients with low-risk endometrial cancer, laparoscopic surgery does not influence the survival outcome when compared to laparotomy.

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Prognostic significance of positive peritoneal cytology in resectable pancreatic cancer: a systemic review and meta-analysis

Oncotarget ◽

10.18632/oncotarget.14745 ◽

2017 ◽

Vol 8 (9) ◽

pp. 15004-15013 ◽

Cited By ~ 3

Author(s):

Feng Cao ◽

Jia Li ◽

Ang Li ◽

Fei Li

Keyword(s):

Pancreatic Cancer ◽

Meta Analysis ◽

Prognostic Significance ◽

Systemic Review ◽

Peritoneal Cytology ◽

Resectable Pancreatic Cancer ◽

Positive Peritoneal Cytology

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Localized pancreatic cancer with positive peritoneal cytology as a sole manifestation of metastatic disease: a single-institution experience

The American Journal of Surgery ◽

10.1016/j.amjsurg.2016.04.008 ◽

2017 ◽

Vol 213 (1) ◽

pp. 94-99 ◽

Cited By ~ 2

Author(s):

Stephen Y. Oh ◽

Alicia Edwards ◽

Margaret T. Mandelson ◽

Hejin Hahn ◽

Adnan Alseidi ◽

...

Keyword(s):

Pancreatic Cancer ◽

Metastatic Disease ◽

Peritoneal Cytology ◽

Single Institution ◽

Positive Peritoneal Cytology

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Evaluating survival in patients with pancreatic adenocarcinoma and lung metastasis.

Journal of Clinical Oncology ◽

10.1200/jco.2021.39.15_suppl.e16237 ◽

2021 ◽

Vol 39 (15_suppl) ◽

pp. e16237-e16237

Author(s):

Jason Cham ◽

Aren Ebrahimi ◽

David Jacob Hermel ◽

Samantha R. Spierling Bagsic ◽

Darren Sigal

Keyword(s):

Pancreatic Cancer ◽

Health System ◽

Pancreatic Adenocarcinoma ◽

Lung Metastasis ◽

Metastatic Disease ◽

Lung Metastases ◽

Secondary Outcome ◽

Number Of Patients ◽

Isolated Lung ◽

Significant Difference

e16237 Background: Pancreatic adenocarcinoma most commonly metastasizes to the liver and peritoneum, yet can occasionally metastasize to the lungs in an isolated fashion. Anecdotal evidence suggests that patients who have isolated metastatic disease to the lungs have improved outcomes. We sought to investigate whether pancreatic cancer lung metastasis is associated with improved survival. Methods: We conducted a retrospective review of patients within the Scripps Health system with pathologically confirmed pancreatic adenocarcinoma from 2017 to 2020. Primary sites of metastatic disease were identified with imaging, and when available, confirmed by pathology. A subgroup of 101 patients from a total cohort of 598 patients was further refined to only include patients with lung and/or liver primary metastases (N=68). Analyses were conducted on subgroups defined by metastatic sites of disease in the liver only, lung only and combined liver+lung. Primary and secondary outcome analyses compared isolated lung versus liver/liver+lung. Overall survival (OS) was defined from the date of diagnosis to date of death or most recent follow up, and recurrence free survival (RFS) from the time of diagnosis to date of recurrence. Each survival outcome was analyzed using Cox Proportional Hazards tests. Additionally, proportions of each subgroup (lung v. liver/liver+lung) that had recurrence or were deceased were reported and compared by Fisher’s exact tests. Results: No significant differences were observed in OS (HR 1.91, CI 0.66 – 3.73; p= 0.311) or RFS (HR 0.98, CI 0.42 – 2.30; p= 0.968) between patients with primary lung metastases versus those with either liver or liver+lung metastases (reported as hazard ratios of liver/liver+lung relative to lung only). Although there was no overall statistically significant difference, the kaplan-meier curve for OS appears to show improved survival for patients with primary lung metastasis initially but then ultimately shows worse survival compared to liver only metastasis at later time points. Please see Table.Conclusions: We found no difference in survival outcomes among pancreatic cancer patients with only lung metastasis at diagnosis compared to patients with hepatic metastasis. However, we do observe that patients with lung metastases seem to have improved survival initially. This study was conducted on a small set of the total number of patients with pancreatic adenocarcinoma within the Scripps Health system. Further analysis is ongoing to confirm the trend we observe in this study.[Table: see text]

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Re-thinking the prognostic significance of positive peritoneal cytology in endometrial cancer

Gynecologic Oncology ◽

10.1016/j.ygyno.2021.01.007 ◽

2021 ◽

Vol 161 (1) ◽

pp. 135-142 ◽

Cited By ~ 1

Author(s):

Masataka Takenaka ◽

Misato Kamii ◽

Yasushi Iida ◽

Nozomu Yanaihara ◽

Jiro Suzuki ◽

...

Keyword(s):

Endometrial Cancer ◽

Prognostic Significance ◽

Peritoneal Cytology ◽

Positive Peritoneal Cytology

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Adjuvant and Neoadjuvant Therapy for Pancreatic Adenocarcinoma

10.2310/7800.16076 ◽

2017 ◽

Author(s):

Gregory C Wilson ◽

Brent T Xia ◽

Syed A Ahmed

Keyword(s):

Pancreatic Cancer ◽

Adjuvant Therapy ◽

Neoadjuvant Therapy ◽

Pancreatic Adenocarcinoma ◽

Locally Advanced ◽

Neoadjuvant Treatment ◽

Advanced Pancreatic Cancer ◽

Treatment Strategies ◽

Ductal Adenocarcinoma ◽

Borderline Resectable

Despite decades of advancement and research into the multimodal care of pancreatic cancer, mortality after the diagnosis of pancreatic ductal adenocarcinoma remains grim. The role of adjuvant therapy following surgical resection has been well established in the literature. However, adjuvant therapy is imperfect, and outside of a clinical trial, there are high rates of omission or delayed initiation of therapy. Neoadjuvant treatment strategies continue to be explored in the management of resectable, borderline-resectable, and locally advanced unresectable pancreatic adenocarcinoma. With improved resection rates and the possibility for tumor downstaging, neoadjuvant therapy has become standard for patients with borderline-resectable and locally advanced unresectable tumors. Additional benefits of neoadjuvant therapy in the treatment of resectable tumors include improved completion rates of systemic therapy and R0 resection rates. Future clinical trials, including the use of novel treatment agents and combination treatment strategies in both neoadjuvant and adjuvant regimens, will add value to the treatment of pancreatic adenocarcinoma. Key words: adjuvant therapy, borderline-resectable pancreatic cancer, locally advanced pancreatic cancer, neoadjuvant therapy, pancreatic adenocarcinoma, resectable disease

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The Tumour Marker CA 195 in Colorectal and Pancreatic Cancer

The International Journal of Biological Markers ◽

10.1177/172460089100600405 ◽

1991 ◽

Vol 6 (4) ◽

pp. 241-246 ◽

Cited By ~ 4

Author(s):

P.M. Sagar ◽

O.M. Taylor ◽

E.H. Cooper ◽

E.A. Benson ◽

M.J. Mcmahon ◽

...

Keyword(s):

Colorectal Cancer ◽

Pancreatic Cancer ◽

Serum Level ◽

Pancreatic Adenocarcinoma ◽

Metastatic Disease ◽

Initial Level ◽

Tumour Marker ◽

Tumour Markers ◽

Normal Range ◽

Unresectable Disease

The aim of this study was to measure the serum level of the tumour markers CA 195 and CEA in patients with either colorectal or pancreatic cancer both before and at serial intervals after operation. CA 195 and CEA were measured in 199 patients with colorectal cancer and 52 patients with pancreatic cancer. The median concentrations of CA 195 were 3.0 u/ml (interquartile range 3.0-4.5 u/ml) in patients with a Dukes’ stage A lesion, 5.8 u/ml (3.0-18.2 u/ml) in patients with a Dukes’ stage B lesion, 6.1 u/ml (3.0-24.7 u/ml) in patients with a Dukes’ stage C and 23.8 u/ml (11.1-409.0 u/ml) in patients with metastatic disease (normal range 0-7 u/ml). The median levels of CEA were 2.6 ng/ml (1.7-3.3 ng/ml) for Dukes’ stage A, 3.3 ng/ml (1.7-7.2 ng/ml) for Dukes’ stage B, 3.7 ng/ml (2.2-7.9 ng/ml) for Dukes’ stage C and 34.5 ng/ml (13.3-289.4 ng/ml) for metastatic disease. A rising level of CA 195 or CEA after operation suggested recurrence of the tumour. In none of these patients was the recurrence operable. In patients with pancreatic adenocarcinoma, the level of CA 195 was significantly higher in patients with metastatic disease but it did not discriminate between resectable and unresectable disease. The duration of survival correlated with the initial level of CA 195 (Rs = –0.66, p < 0.001).

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The prognostic significance of positive peritoneal cytology in endometrial cancer

International Journal of Gynecological Cancer ◽

10.1046/j.1525-1438.1996.06060473.x ◽

1996 ◽

Vol 6 (6) ◽

pp. 473-476 ◽

Cited By ~ 6

Author(s):

S.S.T. Lo ◽

D.K.L. Cheng ◽

T.Y. Ng ◽

L.C. Wong ◽

H.Y.S. Ngan

Keyword(s):

Endometrial Cancer ◽

Prognostic Significance ◽

Peritoneal Cytology ◽

Positive Peritoneal Cytology

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Prognostic Significance of Microvessel Density Determining by Endoglin in Stage II Rectal Carcinoma: A Retrospective Analysis

Gastroenterology Research and Practice ◽

10.1155/2015/504179 ◽

2015 ◽

Vol 2015 ◽

pp. 1-9 ◽

Cited By ~ 3

Author(s):

Zeljko Martinovic ◽

Drazen Kovac ◽

Mia Martinovic

Keyword(s):

Rectal Cancer ◽

Survival Rates ◽

Prognostic Significance ◽

Normal Mucosa ◽

Tumor Location ◽

Integrated System ◽

Stage Ii ◽

Rank Test ◽

Adjacent Mucosa ◽

Significant Difference

Background. The role of endoglin in the Dukes B rectal cancer is still unexplored. The aim of this study was to examine the expression of endoglin (CD105) in resected rectal cancer and to evaluate the relationship between microvessels density (MVD), clinicopathological factors, and survival rates.Methods. The study included 95 primary rectal adenocarcinomas, corresponding to 67 adjacent and 73 distant normal mucosa specimens from surgical resection samples. Tumor specimens were paraffin-embedded and immunohistochemical staining for the CD105 endothelial antigen was performed to count CD105-MVD. For exact measurement of the CD105-MVD used a computer-integrated system Alphelys Spot Browser 2 was used.Results. The intratumoral CD105-MVD was significantly higher compared with corresponding adjacent mucosa (P<0.0001) and distant mucosa specimens (P<0.0001). There was no significant difference in the CD105-MVD according to patients age, gender, tumor location, grade of differentiation, histological type, depth of tumor invasion, and tumor size. The overall survival rate was significantly higher in the low CD105-MVD group of patients than in the high CD105-MVD group of patients (log-rank test,P=0.0406).Conclusion. CD105-assessed MVD could help to identify patients with possibility of poor survival in the group of stage II RC.

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