Prognostic significance of peritoneal washing cytology in patients with gastric cancer

Background: Positive peritoneal washing cytology is a poor prognostic factor in patients with gastric cancer. The right therapeutic approach for this condition has not been well documented. Methods: Patients who underwent surgery for gastric cancer with suspected serosal invasion and peritoneal wash...

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Veröffentlicht in:British journal of surgery 2012-03, Vol.99 (3), p.397-403
Hauptverfasser: Lee, S. D., Ryu, K. W., Eom, B. W., Lee, J. H., Kook, M. C., Kim, Y.-W.
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container_issue 3
container_start_page 397
container_title British journal of surgery
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creator Lee, S. D.
Ryu, K. W.
Eom, B. W.
Lee, J. H.
Kook, M. C.
Kim, Y.-W.
description Background: Positive peritoneal washing cytology is a poor prognostic factor in patients with gastric cancer. The right therapeutic approach for this condition has not been well documented. Methods: Patients who underwent surgery for gastric cancer with suspected serosal invasion and peritoneal washing cytology at the Korean National Cancer Centre between May 2001 and December 2009 were included in this retrospective study. Clinicopathological factors and overall survival were analysed with respect to the cytological results and presence of peritoneal metastases. Prognostic factors were analysed in patients with positive cytology but without overt peritoneal metastases. Results: A total of 1072 patients were included in the analysis, of whom 900 had negative cytology (C0 group) and 172 had positive cytology (C1 group). No peritoneal metastases (P0) were found in 830 patients (92·2 per cent) in the C0 group. Peritoneal metastases (P1) were found in 76 patients (44·2 per cent) in the C1 group. Median overall survival times in the P0 C1, P1 C0 and P1 C1 subgroups were 20·0, 14·0 and 10·0 months respectively. Multivariable analysis of the P0 C1 subgroup revealed that clinical N0–2 category and gastric resection were significantly associated with better prognosis (median survival 24·0 versus 13·0 months for N0–2 versus N3, and 21·0 versus 4·0 months for resected versus non‐resected). Conclusion: Positive washing cytology in patients with gastric cancer is a negative prognostic factor for patients with, as well as those without, overt peritoneal metastases. Resection is an option in patients with clinical stage N0–2 disease without peritoneal metastases but with a positive washing cytology finding. Copyright © 2011 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd. Positive cytology predicts poor prognosis
doi_str_mv 10.1002/bjs.7812
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D. ; Ryu, K. W. ; Eom, B. W. ; Lee, J. H. ; Kook, M. C. ; Kim, Y.-W.</creator><creatorcontrib>Lee, S. D. ; Ryu, K. W. ; Eom, B. W. ; Lee, J. H. ; Kook, M. C. ; Kim, Y.-W.</creatorcontrib><description>Background: Positive peritoneal washing cytology is a poor prognostic factor in patients with gastric cancer. The right therapeutic approach for this condition has not been well documented. Methods: Patients who underwent surgery for gastric cancer with suspected serosal invasion and peritoneal washing cytology at the Korean National Cancer Centre between May 2001 and December 2009 were included in this retrospective study. Clinicopathological factors and overall survival were analysed with respect to the cytological results and presence of peritoneal metastases. Prognostic factors were analysed in patients with positive cytology but without overt peritoneal metastases. Results: A total of 1072 patients were included in the analysis, of whom 900 had negative cytology (C0 group) and 172 had positive cytology (C1 group). No peritoneal metastases (P0) were found in 830 patients (92·2 per cent) in the C0 group. Peritoneal metastases (P1) were found in 76 patients (44·2 per cent) in the C1 group. Median overall survival times in the P0 C1, P1 C0 and P1 C1 subgroups were 20·0, 14·0 and 10·0 months respectively. Multivariable analysis of the P0 C1 subgroup revealed that clinical N0–2 category and gastric resection were significantly associated with better prognosis (median survival 24·0 versus 13·0 months for N0–2 versus N3, and 21·0 versus 4·0 months for resected versus non‐resected). Conclusion: Positive washing cytology in patients with gastric cancer is a negative prognostic factor for patients with, as well as those without, overt peritoneal metastases. Resection is an option in patients with clinical stage N0–2 disease without peritoneal metastases but with a positive washing cytology finding. Copyright © 2011 British Journal of Surgery Society Ltd. Published by John Wiley &amp; Sons, Ltd. Positive cytology predicts poor prognosis</description><identifier>ISSN: 0007-1323</identifier><identifier>EISSN: 1365-2168</identifier><identifier>DOI: 10.1002/bjs.7812</identifier><identifier>PMID: 22101572</identifier><identifier>CODEN: BJSUAM</identifier><language>eng</language><publisher>Chichester, UK: John Wiley &amp; Sons, Ltd</publisher><subject>Aged ; Ascitic Fluid - pathology ; Biological and medical sciences ; Female ; Gastrectomy - mortality ; Gastroenterology. Liver. Pancreas. Abdomen ; General aspects ; Humans ; Male ; Medical sciences ; Middle Aged ; Neoplasm Invasiveness ; Neoplasm Seeding ; Peritoneal Lavage - methods ; Peritoneal Neoplasms - mortality ; Peritoneal Neoplasms - pathology ; Peritoneal Neoplasms - secondary ; Prognosis ; Retrospective Studies ; Stomach Neoplasms - mortality ; Stomach Neoplasms - pathology ; Stomach Neoplasms - surgery ; Stomach. Duodenum. Small intestine. Colon. Rectum. Anus ; Survival Analysis ; Tumors</subject><ispartof>British journal of surgery, 2012-03, Vol.99 (3), p.397-403</ispartof><rights>Copyright © 2011 British Journal of Surgery Society Ltd. 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D.</creatorcontrib><creatorcontrib>Ryu, K. W.</creatorcontrib><creatorcontrib>Eom, B. W.</creatorcontrib><creatorcontrib>Lee, J. H.</creatorcontrib><creatorcontrib>Kook, M. C.</creatorcontrib><creatorcontrib>Kim, Y.-W.</creatorcontrib><title>Prognostic significance of peritoneal washing cytology in patients with gastric cancer</title><title>British journal of surgery</title><addtitle>Br J Surg</addtitle><description>Background: Positive peritoneal washing cytology is a poor prognostic factor in patients with gastric cancer. The right therapeutic approach for this condition has not been well documented. Methods: Patients who underwent surgery for gastric cancer with suspected serosal invasion and peritoneal washing cytology at the Korean National Cancer Centre between May 2001 and December 2009 were included in this retrospective study. Clinicopathological factors and overall survival were analysed with respect to the cytological results and presence of peritoneal metastases. Prognostic factors were analysed in patients with positive cytology but without overt peritoneal metastases. Results: A total of 1072 patients were included in the analysis, of whom 900 had negative cytology (C0 group) and 172 had positive cytology (C1 group). No peritoneal metastases (P0) were found in 830 patients (92·2 per cent) in the C0 group. Peritoneal metastases (P1) were found in 76 patients (44·2 per cent) in the C1 group. Median overall survival times in the P0 C1, P1 C0 and P1 C1 subgroups were 20·0, 14·0 and 10·0 months respectively. Multivariable analysis of the P0 C1 subgroup revealed that clinical N0–2 category and gastric resection were significantly associated with better prognosis (median survival 24·0 versus 13·0 months for N0–2 versus N3, and 21·0 versus 4·0 months for resected versus non‐resected). Conclusion: Positive washing cytology in patients with gastric cancer is a negative prognostic factor for patients with, as well as those without, overt peritoneal metastases. Resection is an option in patients with clinical stage N0–2 disease without peritoneal metastases but with a positive washing cytology finding. Copyright © 2011 British Journal of Surgery Society Ltd. Published by John Wiley &amp; Sons, Ltd. Positive cytology predicts poor prognosis</description><subject>Aged</subject><subject>Ascitic Fluid - pathology</subject><subject>Biological and medical sciences</subject><subject>Female</subject><subject>Gastrectomy - mortality</subject><subject>Gastroenterology. Liver. Pancreas. Abdomen</subject><subject>General aspects</subject><subject>Humans</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Neoplasm Invasiveness</subject><subject>Neoplasm Seeding</subject><subject>Peritoneal Lavage - methods</subject><subject>Peritoneal Neoplasms - mortality</subject><subject>Peritoneal Neoplasms - pathology</subject><subject>Peritoneal Neoplasms - secondary</subject><subject>Prognosis</subject><subject>Retrospective Studies</subject><subject>Stomach Neoplasms - mortality</subject><subject>Stomach Neoplasms - pathology</subject><subject>Stomach Neoplasms - surgery</subject><subject>Stomach. Duodenum. Small intestine. Colon. Rectum. 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C.</creator><creator>Kim, Y.-W.</creator><general>John Wiley &amp; Sons, Ltd</general><general>Wiley</general><scope>BSCLL</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>7X8</scope></search><sort><creationdate>201203</creationdate><title>Prognostic significance of peritoneal washing cytology in patients with gastric cancer</title><author>Lee, S. D. ; Ryu, K. W. ; Eom, B. W. ; Lee, J. H. ; Kook, M. C. ; Kim, Y.-W.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3892-4e53e3729fc8a22d8a4e7e59afdd57b9134dec91ac44c2cc850a9382e2a643a83</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2012</creationdate><topic>Aged</topic><topic>Ascitic Fluid - pathology</topic><topic>Biological and medical sciences</topic><topic>Female</topic><topic>Gastrectomy - mortality</topic><topic>Gastroenterology. Liver. Pancreas. Abdomen</topic><topic>General aspects</topic><topic>Humans</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Neoplasm Invasiveness</topic><topic>Neoplasm Seeding</topic><topic>Peritoneal Lavage - methods</topic><topic>Peritoneal Neoplasms - mortality</topic><topic>Peritoneal Neoplasms - pathology</topic><topic>Peritoneal Neoplasms - secondary</topic><topic>Prognosis</topic><topic>Retrospective Studies</topic><topic>Stomach Neoplasms - mortality</topic><topic>Stomach Neoplasms - pathology</topic><topic>Stomach Neoplasms - surgery</topic><topic>Stomach. Duodenum. Small intestine. Colon. Rectum. Anus</topic><topic>Survival Analysis</topic><topic>Tumors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Lee, S. D.</creatorcontrib><creatorcontrib>Ryu, K. W.</creatorcontrib><creatorcontrib>Eom, B. W.</creatorcontrib><creatorcontrib>Lee, J. H.</creatorcontrib><creatorcontrib>Kook, M. C.</creatorcontrib><creatorcontrib>Kim, Y.-W.</creatorcontrib><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>MEDLINE - Academic</collection><jtitle>British journal of surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Lee, S. D.</au><au>Ryu, K. W.</au><au>Eom, B. W.</au><au>Lee, J. H.</au><au>Kook, M. C.</au><au>Kim, Y.-W.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Prognostic significance of peritoneal washing cytology in patients with gastric cancer</atitle><jtitle>British journal of surgery</jtitle><addtitle>Br J Surg</addtitle><date>2012-03</date><risdate>2012</risdate><volume>99</volume><issue>3</issue><spage>397</spage><epage>403</epage><pages>397-403</pages><issn>0007-1323</issn><eissn>1365-2168</eissn><coden>BJSUAM</coden><abstract>Background: Positive peritoneal washing cytology is a poor prognostic factor in patients with gastric cancer. The right therapeutic approach for this condition has not been well documented. Methods: Patients who underwent surgery for gastric cancer with suspected serosal invasion and peritoneal washing cytology at the Korean National Cancer Centre between May 2001 and December 2009 were included in this retrospective study. Clinicopathological factors and overall survival were analysed with respect to the cytological results and presence of peritoneal metastases. Prognostic factors were analysed in patients with positive cytology but without overt peritoneal metastases. Results: A total of 1072 patients were included in the analysis, of whom 900 had negative cytology (C0 group) and 172 had positive cytology (C1 group). No peritoneal metastases (P0) were found in 830 patients (92·2 per cent) in the C0 group. Peritoneal metastases (P1) were found in 76 patients (44·2 per cent) in the C1 group. Median overall survival times in the P0 C1, P1 C0 and P1 C1 subgroups were 20·0, 14·0 and 10·0 months respectively. Multivariable analysis of the P0 C1 subgroup revealed that clinical N0–2 category and gastric resection were significantly associated with better prognosis (median survival 24·0 versus 13·0 months for N0–2 versus N3, and 21·0 versus 4·0 months for resected versus non‐resected). Conclusion: Positive washing cytology in patients with gastric cancer is a negative prognostic factor for patients with, as well as those without, overt peritoneal metastases. Resection is an option in patients with clinical stage N0–2 disease without peritoneal metastases but with a positive washing cytology finding. Copyright © 2011 British Journal of Surgery Society Ltd. Published by John Wiley &amp; Sons, Ltd. Positive cytology predicts poor prognosis</abstract><cop>Chichester, UK</cop><pub>John Wiley &amp; Sons, Ltd</pub><pmid>22101572</pmid><doi>10.1002/bjs.7812</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record>
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source Oxford University Press Journals All Titles (1996-Current); MEDLINE; Wiley Online Library Journals Frontfile Complete
subjects Aged
Ascitic Fluid - pathology
Biological and medical sciences
Female
Gastrectomy - mortality
Gastroenterology. Liver. Pancreas. Abdomen
General aspects
Humans
Male
Medical sciences
Middle Aged
Neoplasm Invasiveness
Neoplasm Seeding
Peritoneal Lavage - methods
Peritoneal Neoplasms - mortality
Peritoneal Neoplasms - pathology
Peritoneal Neoplasms - secondary
Prognosis
Retrospective Studies
Stomach Neoplasms - mortality
Stomach Neoplasms - pathology
Stomach Neoplasms - surgery
Stomach. Duodenum. Small intestine. Colon. Rectum. Anus
Survival Analysis
Tumors
title Prognostic significance of peritoneal washing cytology in patients with gastric cancer
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