scholarly journals Clinical Significance of Peritoneal Fluid Examination for Free Cancer Cells in Patients Qualified for Surgery for Gastric Cancer

2021 ◽  
Vol 8 ◽  
Author(s):  
Sławomir Cieśla ◽  
Radosław Lisiecki ◽  
Agnieszka Ławnicka ◽  
Bartosz Kudliński ◽  
Paulina Ostrowska ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Surgical Treatment ◽  
Cancer Cells ◽  
Peritoneal Lavage ◽  
Immunohistochemical Analysis ◽  
Term Survival ◽  
Entire Study ◽  
Peritoneal Lavage Cytology ◽  
Risk Of Death ◽  
Increased Risk

Background: Peritoneal lavage cytology in patients with gastric cancer may correlate with an unfavorable prognosis. This study evaluated the presence of free cancer cells in the peritoneal lavage of a population of patients with gastric cancer and its correlation with the outcome of surgical treatment.Methods: One hundred patients diagnosed with gastric or gastrointestinal junction adenocarcinoma underwent surgery. In all patients, a cytological and immunohistochemical analysis of peritoneal lavage was performed. Based on the presence of free cancer cells (fcc) at the cytological and immunohistochemical examination of peritoneal lavage, patients undergoing surgery for gastric cancer were divided into two groups: fcc (+) and fcc (–).Results: A total of 100 patients, 37 women, and 63 men with a median age of 65 years were included in the study. In the entire study group, 16 (16%) patients were positive for the presence of free cancer cells (fcc +) at peritoneal lavage examination. However, in the group of patients who underwent gastrectomy, fcc (+) was found in 10 out of 77 (13%) patients. The presence of cancer cells in peritoneal lavage was a strong predictive factor in an unfavorable outcome after surgery, and 1-year and 2-year patient survival was 34 and 0% in fcc (+) patients and 79 and 59% in fcc (–), respectively. Moreover, the presence of free cancer cells was associated with a five-fold increased risk of death within 2 years after surgery. When analyzing the group of patients undergoing R0/R1 surgery, this difference was even more significant (p < 0.0001).Conclusions: The presence of free cancer cells in peritoneal lavage may significantly affect the outcome of patients with gastric cancer. Radical surgery in patients with free cancer cells in the peritoneal lavage did not result in a survival advantage. Identification of free cancer cells could help for a better stratification of gastric cancer patients, identifying those patients who could better benefit from a radical surgical treatment, finally improving long-term survival.

Is the peritoneal lavage cytology coincided with peritoneal metastasis for gastric cancer?

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e16533-e16533
Author(s):  
Wei Wang ◽  
Wenjun Xiong ◽  
Yaohui Peng ◽  
Jin Li ◽  
Haipeng Huang ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Cancer Cells ◽  
Peritoneal Metastasis ◽  
Peritoneal Lavage ◽  
Peritoneal Lavage Cytology ◽  
Peritoneal Carcinomatosis Index ◽  
Positive Rate ◽  
Lavage Cytology ◽  
The Right

e16533 Background: Gastric cancer (GC) with peritoneal metastasis (PM) is associated with a poor prognosis. The free cancer cells are the prerequisite of peritoneal metastasis. Peritoneal lavage cytology (PLC) is the main measure to identify the free cancer cells, but its positive rate is relatively low. This study aims to investigate the association between the result PLC and peritoneal metastasis for GC. Methods: From November 2017 to December 2019, 33 patients with GC were confirmed with PM through computerized tomography or diagnostic laparoscopy. The inflow and outflow catheters were inserted laparoscopically in all patients for postoperative hyperthermic intraperitoneal chemotherapy. PLC was performed with at least 200 ml of fluid and examined by measures of cytology and immunocytopathology. Ascites was aspirated if detected or 500 milliliter of normal saline infused the Douglas cavity, para-colic gutters and the right and left sub-phrenic cavity and then aspirated. Results: There were 15 males and 18 females and the median age was 56 (24-84) years old. All patients had a cT4a/cT4b and an N-positive tumor. The overall positive PLC (PLC+) rate was 63.6% (21/33). The distribution of Lauren classification was respectively 5 (15.2%) intestinal, 26 (78.8%) diffused and 2 (6.1%) mixed tumor. The diffused cases had a higher rate of PLC+ ( P = 0.004). All 5 intestinal GC had a negative PLC (PLC-). 71.4% (20/28) of patients with a grade G3/G4 had a PLC+, compared, no PLC+ was recorded in 5 grade G1/G2 patients (P = 0.003). The median peritoneal carcinomatosis index (PCI) was 14 (1-39). The PLC+ rate was 94.7% (18/19) in PCI > = 10 group and 21.4% (3/14) in PCI < 10 group ( P < 0.001). The median ascites was 200 (0-7000) ml. The PLC+ rate was 88.2% 15/17) in ascites > = 200 ml group and 37.5% (6/16) in ascites < 10 ml ( P = 0.002). The median follow-up was 13(1-27) months and the overall survival was 75.8%, but no significance was detected between PLC+ group and PLC- group. Conclusions: The present study suggested that the result of PLC was not completely coincided with PM for GC by measures of cytology and immunocytopathology, especially for intestinal and grade G1/G2 tumor.

scholarly journals Undifferentiated Embryonal Sarcoma of the Liver in Children Versus Adults: A National Cancer Database Analysis

Cancers ◽  
2021 ◽  
Vol 13 (12) ◽  
pp. 2918
Author(s):  
Ioannis A. Ziogas ◽  
Irving J. Zamora ◽  
Harold N. Lovvorn III ◽  
Christina E. Bailey ◽  
Sophoclis P. Alexopoulos
Keyword(s):  
Surgical Treatment ◽  
Cox Regression ◽  
Clinicopathological Characteristics ◽  
National Cancer Database ◽  
Term Survival ◽  
Long Term Survival ◽  
Risk Of Mortality ◽  
Increased Risk ◽  
Embryonal Sarcoma

This study evaluates the clinicopathological characteristics and outcomes of children vs. adults with undifferentiated embryonal sarcoma of the liver (UESL). A retrospective analysis of 82 children (<18 years) and 41 adults (≥18 years) with UESL registered in the National Cancer Database between 2004–2015 was conducted. No between-group differences were observed regarding tumor size, metastasis, surgical treatment, margin status, and radiation. Children received chemotherapy more often than adults (92.7% vs. 65.9%; p < 0.001). Children demonstrated superior overall survival vs. adults (log-rank, p < 0.001) with 5-year rates of 84.4% vs. 48.2%, respectively. In multivariable Cox regression for all patients, adults demonstrated an increased risk of mortality compared to children (p < 0.001), while metastasis was associated with an increased (p = 0.02) and surgical treatment with a decreased (p = 0.001) risk of mortality. In multivariable Cox regression for surgically-treated patients, adulthood (p = 0.004) and margin-positive resection (p = 0.03) were independently associated with an increased risk of mortality. Multimodal treatment including complete surgical resection and chemotherapy results in long-term survival in most children with UESL. However, adults with UESL have poorer long-term survival that may reflect differences in disease biology and an opportunity to further refine currently available treatment schemas.

scholarly journals Intraoperative peritoneal lavage cytology offers prognostic significance for gastric cancer patients with curative resection

2017 ◽  
Vol 108 (5) ◽  
pp. 978-986 ◽  
Author(s):  
Eiji Higaki ◽  
Shinya Yanagi ◽  
Naoto Gotohda ◽  
Takahiro Kinoshita ◽  
Takeshi Kuwata ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Cancer Patients ◽  
Curative Resection ◽  
Peritoneal Lavage ◽  
Prognostic Significance ◽  
Peritoneal Lavage Cytology ◽  
Lavage Cytology ◽  
Gastric Cancer Patients

Relevance of peritoneal lavage cytology before and after gastrectomy in CY1 and R1 surgery for primary advanced gastric cancer

2005 ◽  
Vol 23 (16_suppl) ◽  
pp. 4198-4198
Author(s):  
O. Kobayashi ◽  
A. Tsuburaya ◽  
T. Yoshikawa ◽  
T. Osaragi ◽  
H. Murakami ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Advanced Gastric Cancer ◽  
Peritoneal Lavage ◽  
Peritoneal Lavage Cytology ◽  
Before And After ◽  
Lavage Cytology

Survival and prognosticators of gastric cancer patients with only positive peritoneal lavage cytology.

2016 ◽  
Vol 34 (4_suppl) ◽  
pp. 16-16
Author(s):  
Kazuki Kano ◽  
Tsutomu Sato ◽  
Yukio Maezawa ◽  
Kenki Segami ◽  
Tetsushi Nakajima ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Overall Survival ◽  
Proportional Hazards Model ◽  
Peritoneal Lavage ◽  
Multivariate Analyses ◽  
Cox Proportional Hazards ◽  
Cox Proportional Hazards Model ◽  
Peritoneal Cytology ◽  
Peritoneal Lavage Cytology ◽  
Lavage Cytology

16 Background: Treatment strategies for only positive peritoneal lavage cytology findings have not yet been established. The objective of this retrospective study was to clarify the survival and prognosticators in these patients. Methods: Overall survival (OS) rates were examined in 39 patients with gastric cancer who underwent a curative resection and had positive peritoneal cytology in the absence of overt peritoneal metastases between January 2000 and June 2015. Univariate and multivariate analyses were performed to identify risk factors using a Cox proportional hazards model. Results: A total of 39 patients were evaluated. The median overall survival was significantly longer in the 34 patients who received chemotherapy after surgery than that in the 5 who did not (19.1 vs 5.9 months, p < 0.01). Among the patients who received chemotherapy after surgery, univariate and multivariate analyses showed that pN3b was an independent significant prognosticator (hazard ratio of 4.169 with 95% CI: 1.108-15.684, p = 0.035). The median OS was 15.8 months when the patients diagnosed with N3b was 33.1 months when the patients diagnosed with N3a or lower. Conclusions: The prognosis of gastric carcinoma with positive peritoneal lavage cytology without peritoneal metastasis is still poor and need more aggressive treatment. The lymph node metastasis was a significant prognosticator in these patients.

Survival after surgical treatment of early gastric cancer: surgical techniques and long-term survival

2004 ◽  
Vol 389 (2) ◽  
pp. 69-74 ◽  
Author(s):  
Shiro Kikuchi ◽  
Natsuya Katada ◽  
Shinichi Sakuramoto ◽  
Nobuyuki Kobayashi ◽  
Hitoshi Shimao ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Surgical Treatment ◽  
Early Gastric Cancer ◽  
Surgical Techniques ◽  
Term Survival ◽  
Long Term Survival

Analysis Of Risk Factors Of Positive Peritoneal Cytology In Patients Treated For Gastric Cancer – Preliminary Report*

2015 ◽  
Vol 87 (10) ◽  
Author(s):  
Radosław Lisiecki ◽  
Arkadiusz Spychała ◽  
Katarzyna Pater ◽  
Dawid Murawa
Keyword(s):  
Gastric Cancer ◽  
Surgical Treatment ◽  
Cancer Cells ◽  
Peritoneal Cavity ◽  
Peritoneal Metastases ◽  
Histological Type ◽  
Gastric Body ◽  
Peritoneal Cytology ◽  
Positive Cytology ◽  
Positive Peritoneal Cytology

AbstractPresence of free gastric cancer cells in the peritoneal cavity of patients who underwent surgical treatment for gastric cancer is a negative prognostic factor and caused rapid disease recurrence, manifested as peritoneal metastases.Positive peritoneal cytology despite lack of visible peritoneal metastases was regarded as M1 class in the TNM classification (7was to analyze factors associated with positive peritoneal cytology and identify groups of patients in whom diagnostic laparoscopy plus peritoneal lavage in the diagnostic process could affect therapeutic decisions.The study enrolled patients with gastric cancer who underwent surgical treatment at the Department of Surgery, Wielkopolskie Oncology Center in Poznań. During the laparotomy, after opening of the peritoneal cavity, 200 ml of physiological saline at 37°C was administered in the tumor region. After this fluid was mixed, 100 ml of lavage fluid was collected. This fluid was subsequently spun many times to obtain sediment for cytology and immunohistochemistry investigation using anti-BerEp-4, CK 7/20, and B72.3.Results of peritoneal cytology were analyzed jointly with clinical factors – patient’s age, sex and pathology factors – tumor invasion, involvement of lymph nodes, histological grade, histological type according to Lauren and localization of the cancer in the stomach.Analysis of the peritoneal fluid for presence of free cancer cells was done in 51 patients. Positive peritoneal cytology was found in 12 (23.5%) patients. In the group of patients with positive cytology, all patients had T3/T4 tumors and all were found to have lymph node metastases, while G3 cancer was found in 83.3% of patients. In patients with positive cytology, diffuse gastric cancer according to Lauren predominated (9 of 12 patients, 75%), while in patients with negative cytology – intestinal type (20 of 39 patients, 51.2%). In the group of patients with positive histology, the whole stomach was involved by the cancer process in 7 of 12 patients (58.3%), while in the group with negative histology, in 29 of 39 patients the tumor was located in the gastric body and prepyloric part (74.4%).Based on this study we can conclude that determinants of positive peritoneal cytology include: tumor stage T3/T4, N+, G3, cancer located in the whole stomach, diffuse histological type according to Lauren.

When Is Curative Gastrectomy Justified for Gastric Cancer with Positive Peritoneal Lavage Cytology but Negative Macroscopic Peritoneal Implant?

2005 ◽  
Vol 29 (9) ◽  
pp. 1131-1134 ◽  
Author(s):  
Isao Miyashiro ◽  
Ko Takachi ◽  
Yuichiro Doki ◽  
Osamu Ishikawa ◽  
Hiroaki Ohigashi ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Peritoneal Lavage ◽  
Curative Gastrectomy ◽  
Peritoneal Lavage Cytology ◽  
Peritoneal Implant ◽  
Lavage Cytology
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