Evaluation of Introperative Peritoneal Lavage Cytology in Gastric Cancer.

概要

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Intraoperative peritoneal lavage cytology was performed in 165 patients with gastric cancer. We determined that Class IV and Class V cells in Papanicolaou's classification were positive for malignant cells [cy (+)] and that Class I-Class III were negative [cy (-)]. The incidence of cy (+) was 24.8% among all patients. The 50% survival times of patients that had peritoneal dissemination [P (+)] and were cy (+) was 5.5 months. The 50% survival times of patients without peritoneal dissemination [P (-)] and who were cy (+), who were P (+) and cy (-), who were P (-) and cy (-), and whose lesions were non-resectable were 11.9, 22.0, 25.5, and 3.7 months, respectively. The 3-year cumulative survival rate of the P (-) cy (+) patients was higher (9.1%) than that of the P (+) cy (+) patients and "non-resectable"patients, but significantly lower than that of the P (-) cy (-) and P (+) cy (-) patients (p<0.05). There were 11 P (-) cy (+) patients, 9 of whom died of gastric cancer. Peritoneal dissemination was found in five of the nine patients. This suggests that P is not a suitable prognostic factor, and that the cytology of intraoperative peritoneal lavage fluid is more important.
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