Journal ArticleDOI
Value of peritoneal cytology in potentially resectable pancreatic cancer.
Suguru Yamada,Tsutomu Fujii,Mitsuro Kanda,Hiroyuki Sugimoto,S. Nomoto,S. Takeda,Akimasa Nakao,Yasuhiro Kodera +7 more
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TLDR
Peritoneal lavage cytology is used in the diagnosis and staging of various cancers and the clinical significance of positive cytology results in patients with pancreatic cancer is yet to be determined.Abstract:
Background
Peritoneal lavage cytology (CY) is used in the diagnosis and staging of various cancers. The clinical significance of positive cytology results in patients with pancreatic cancer is yet to be determined.
Methods
Peritoneal washing samples were collected from consecutive patients with pancreatic cancer between July 1991 and December 2012. The correlations between cytology results, clinicopathological parameters and recurrence patterns were evaluated. The prognostic impact of CY status, regarding resectability and the effectiveness of adjuvant chemotherapy, were analysed.
Results
Of 523 included patients, 390 underwent resection. Patients with tumours at least 2 cm in diameter were more likely to have CY+ status than patients with tumours smaller than 2 cm (48 of 312 versus 3 of 78 respectively; P = 0·005) and there was a significant correlation between CY+ status and tumour invasion of the anterior pancreatic capsule (43 of 276 versus 8 of 113 with no invasion of the capsule; P = 0·030). Although the overall survival of patients with resected CY+ tumours was worse than that of patients with resected CY− tumours, it was significantly better than the survival of unresected patients regardless of CY status. Multivariable analysis of all patients who had pancreatectomy did not identify CY+ as an independent prognostic factor. Patients with CY+ tumours tended to develop peritoneal metastasis more often than those with CY− tumours, although not significantly so. The median survival time of 34 patients with resected CY+ tumours who received adjuvant chemotherapy was better than that of 17 patients who had surgery alone, although this was not statistically significant (15·3 versus 10·0 months; P = 0·057).
Conclusion
CY+ status is not clinically equivalent to gross peritoneal metastasis in patients with pancreatic cancer. Curative resection is still recommended regardless of CY status.
Presented to the 98th Annual Clinical Congress of the American College of Surgeons, Chicago, Illinois, USA, October 2012read more
Citations
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Journal ArticleDOI
Reappraisal of Peritoneal Washing Cytology in 984 Patients with Pancreatic Ductal Adenocarcinoma Who Underwent Margin-Negative Resection
Sohei Satoi,Yoshiaki Murakami,Fuyuhiko Motoi,Kenichiro Uemura,Manabu Kawai,Masanao Kurata,Masayuki Sho,Ippei Matsumoto,Hiroaki Yanagimoto,Tomohisa Yamamoto,Masamichi Mizuma,Michiaki Unno,Yasushi Hashimoto,Seiko Hirono,Hiroki Yamaue,Goro Honda,Minako Nagai,Yoshiyuki Nakajima,Makoto Shinzeki,Takumi Fukumoto,A-Hon Kwon +20 more
TL;DR: It was showed that patients with M1 disease had acceptable MST after margin-negative resection and a high incidence of peritoneal carcinomatosis within 3 years after surgery, resulting in decreased long-term survival.
Journal ArticleDOI
Prognostic importance of peritoneal washing cytology in patients with otherwise resectable pancreatic ductal adenocarcinoma who underwent pancreatectomy: A nationwide, cancer registry–based study from the Japan Pancreas Society
Hiroyoshi Tsuchida,Tsutomu Fujii,Masamichi Mizuma,Sohei Satoi,Hisato Igarashi,Hidetoshi Eguchi,Tamotsu Kuroki,Yasuhiro Shimizu,Masaji Tani,Satoshi Tanno,Yoshihisa Tsuji,Yoshiki Hirooka,Atsushi Masamune,Kazuhiro Mizumoto,Takao Itoi,Shinichi Egawa,Yuzo Kodama,Shin Hamada,Michiaki Unno,Hiroki Yamaue,Kazuichi Okazaki +20 more
TL;DR: Positive cytology status was an adverse prognostic factor in patients who underwent resection for pancreatic ductal adenocarcinoma but did not preclude attempted curative resection, and adjuvant chemotherapy may contribute to long-term prognosis in patients with positive cytologystatus.
Journal ArticleDOI
Predictors of distant metastasis on exploration in patients with potentially resectable pancreatic cancer
TL;DR: Distant metastasis is still frequently encountered on exploration for patients with potentially resectable PDAC, and younger age, male sex, larger tumor size, low ALT level and high CA19–9 level are independent predictors of unexpected distant metastasis on exploration.
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Pancreatic cancer with malignant ascites: clinical features and outcomes.
Naminatsu Takahara,Hiroyuki Isayama,Yousuke Nakai,Takashi Sasaki,Kei Saito,Tsuyoshi Hamada,Suguru Mizuno,Koji Miyabayashi,Dai Mohri,Hirofumi Kogure,Saburo Matsubara,Natsuyo Yamamoto,Kenji Hirano,Hideaki Ijichi,Keisuke Tateishi,Minoru Tada,Kazuhiko Koike +16 more
TL;DR: Although the prognosis of pancreatic cancer patients with MA remains poor, selected patients may be candidate for chemotherapy, regardless of the timing of appearance of MA.
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The Charlson age comorbidity index predicts prognosis in patients with resected pancreatic cancer
Tomonari Asano,Suguru Yamada,Tsutomu Fujii,Norimitsu Yabusaki,Goro Nakayama,Hiroyuki Sugimoto,Masahiko Koike,Michitaka Fujiwara,Yasuhiro Kodera +8 more
TL;DR: The Charlson age comorbidity index was a significant independent predictor of prognosis and compliance for postoperative adjuvant chemotherapy in the resected pancreatic cancer.
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