Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
Surgery Today
Published in: Surgery Today 6/2015

01-06-2015 | Original Article

Intraoperative dissemination during gastrectomy for gastric cancer associated with serosal invasion

Authors: Yukio Tokumitsu, Shigefumi Yoshino, Michihisa Iida, Kiyoshi Yoshimura, Tomio Ueno, Shoichi Hazama, Masaaki Oka

Published in: Surgery Today | Issue 6/2015

Login to get access

Abstract

Purpose

Free cancer cells shed from the serosal surface of gastric cancer result in peritoneal dissemination. The aim of this study was to clarify the extent of tumor cell implantation due to surgical manipulation during gastrectomy.

Methods

The participants comprised 34 patients who underwent curative gastrectomy for gastric cancer with macroscopic serosal invasion. Two types of cytology were obtained from each patient: (1) cytology from the wound dressing material that covered the serosal invasion area during the operation (Covering Cy), and (2) cytology of the intraperitoneal wash samples (Lavage Cy).

Result

Thirteen patients showed no serosal invasion histopathologically, and all of these patients had negative results for both Lavage Cy and Covering Cy. Among the 21 patients with histopathologically confirmed serosal invasion, six had positive results for both Lavage Cy and Covering Cy, three showed positive findings for Covering Cy alone, one had positive Lavage Cy alone and 11 patients had negative results for both Lavage Cy and Covering Cy. Disseminated recurrence developed in 10 patients. Seven of the nine patients with positive Covering Cy developed disseminated recurrence, compared to three of 12 patients with negative Covering Cy. Positive Covering Cy findings were significantly associated with disseminated recurrence (p < 0.05).

Conclusion

We demonstrated that the intraoperative dissemination of gastric cancer can occur during gastrectomy.
Literature
1.
Homma Y, Ushida S, Yamada M, Kobayashi H, Suzuki K. Positive peritoneal washing cytology in multiple cavities can predict poor prognosis of advanced gastric cancer patients. Ann Surg Oncol. 2010;17:455–60.CrossRefPubMed
2.
Kodera Y, Yamamura Y, Shimizu Y, Torii A, Hirai T, Yasui K, et al. Peritoneal washing cytology: prognostic value of positive findings in patients with gastric carcinoma undergoing a potentially curative resection. J Surg Oncol. 1999;72:60–4 (discussion 4–5).CrossRefPubMed
3.
Suzuki T, Ochiai T, Hayashi H, Hori S, Shimada H, Isono K. Peritoneal lavage cytology findings as prognostic factor for gastric cancer. Semin Surg Oncol. 1999;17:103–7.CrossRefPubMed
4.
Hayes N, Wayman J, Wadehra V, Scott DJ, Raimes SA, Griffin SM. Peritoneal cytology in the surgical evaluation of gastric carcinoma. Br J Cancer. 1999;79:520–4.CrossRefPubMedCentralPubMed
5.
Bando E, Yonemura Y, Takeshita Y, Taniguchi K, Yasui T, Yoshimitsu Y, et al. Intraoperative lavage for cytological examination in 1,297 patients with gastric carcinoma. Am J Surg. 1999;178:256–62.CrossRefPubMed
6.
Fujiwara Y, Doki Y, Taniguchi H, Sohma I, Takiguchi S, Miyata H, et al. Genetic detection of free cancer cells in the peritoneal cavity of the patient with gastric cancer: present status and future perspectives. Gastric Cancer. 2007;10:197–204.CrossRefPubMed
7.
Fukagawa T, Katai H, Saka M, Morita S, Sasajima Y, Taniguchi H, et al. Significance of lavage cytology in advanced gastric cancer patients. World J Surg. 2010;34:563–8.CrossRefPubMed
8.
Oh CA, Bae JM, Oh SJ, Choi MG, Noh JH, Sohn TS, et al. Long-term results and prognostic factors of gastric cancer patients with only positive peritoneal lavage cytology. J Surg Oncol. 2012;105:393–9.CrossRefPubMed
9.
Mezhir JJ, Shah MA, Jacks LM, Brennan MF, Coit DG, Strong VE. Positive peritoneal cytology in patients with gastric cancer: natural history and outcome of 291 patients. Ann Surg Oncol. 2010;17:3173–80.CrossRefPubMed
10.
Glehen O, Gilly FN, Arvieux C, Cotte E, Boutitie F, Mansvelt B, et al. Peritoneal carcinomatosis from gastric cancer: a multi-institutional study of 159 patients treated by cytoreductive surgery combined with perioperative intraperitoneal chemotherapy. Ann Surg Oncol. 2010;17:2370–7.CrossRefPubMed
11.
Schauer M, Peiper M, Theisen J, Knoefel W. Prognostic factors in patients with diffuse type gastric cancer (linitis plastica) after operative treatment. Eur J Med Res. 2011;16:29–33.CrossRefPubMedCentralPubMed
12.
Wu CC, Chen JT, Chang MC, Ho WL, Chen CY, Yeh DC, et al. Optimal surgical strategy for potentially curable serosa-involved gastric carcinoma with intraperitoneal free cancer cells. J Am Coll Surg. 1997;184:611–7.PubMed
13.
Bentrem D, Wilton A, Mazumdar M, Brennan M, Coit D. The value of peritoneal cytology as a preoperative predictor in patients with gastric carcinoma undergoing a curative resection. Ann Surg Oncol. 2005;12:347–53.CrossRefPubMed
14.
Lee SD, Ryu KW, Eom BW, Lee JH, Kook MC, Kim YW. Prognostic significance of peritoneal washing cytology in patients with gastric cancer. Br J Surg. 2012;99:397–403.CrossRefPubMed
15.
Abe S, Yoshimura H, Tabara H, Tachibana M, Monden N, Nakamura T, et al. Curative resection of gastric cancer: limitation of peritoneal lavage cytology in predicting the outcome. J Surg Oncol. 1995;59:226–9.CrossRefPubMed
16.
Li JK, Zheng M, Miao CW, Zhang JH, Ding GH, Wu WS. Peritoneal lavage cytology and carcinoembryonic antigen determination in predicting peritoneal metastasis and prognosis of gastric cancer. World J Gastroenterol. 2005;11:7374–7.PubMed
17.
Han TS, Kong SH, Lee HJ, Ahn HS, Hur K, Yu J, et al. Dissemination of free cancer cells from the gastric lumen and from perigastric lymphovascular pedicles during radical gastric cancer surgery. Ann Surg Oncol. 2011;18:2818–25.CrossRefPubMed
18.
Cetin B, Atalay C, Aslan S, Babacan B, Hatipoglu C, Akinci M, et al. Peritoneal carcinoembryonic antigen level for predicting locoregional and distant spread of gastric cancer. Surg Today. 2005;35:919–24.CrossRefPubMed
19.
Mori N, Oka M, Hazama S, Iizuka N, Yamamoto K, Yoshino S, et al. Detection of telomerase activity in peritoneal lavage fluid from patients with gastric cancer using immunomagnetic beads. Br J Cancer. 2000;83:1026–32.CrossRefPubMedCentralPubMed
20.
Soosay GN, Griffiths M, Papadaki L, Happerfield L, Bobrow L. The differential diagnosis of epithelial-type mesothelioma from adenocarcinoma and reactive mesothelial proliferation. J Pathol. 1991;163:299–305.CrossRefPubMed
21.
Korenaga D, Okuyama T, Orita H, Anai H, Baba H, Maehara Y, et al. Role of intraoperative assessment of lymph node metastasis and serosal invasion in patients with gastric cancer. J Surg Oncol. 1994;55:250–4.CrossRefPubMed
22.
Lee SE, Ryu KW, Nam BH, Lee JH, Choi IJ, Kook MC, et al. Prognostic significance of intraoperatively estimated surgical stage in curatively resected gastric cancer patients. J Am Coll Surg. 2009;209:461–7.CrossRefPubMed
23.
Jeong O, Ryu SY, Jeong MR, Sun JW, Park YK. Accuracy of macroscopic intraoperative diagnosis of serosal invasion and risk of over- and underestimation in gastric carcinoma. World J Surg. 2011;35:2252–8.CrossRefPubMed
24.
Yasuda K, Shiraishi N, Inomata M, Shiroshita H, Izumi K, Kitano S. Prognostic significance of macroscopic serosal invasion in advanced gastric cancer. Hepatogastroenterology. 2007;54:2028–31.PubMed
25.
Huang B, Sun Z, Wang Z, Lu C, Xing C, Zhao B, et al. Factors associated with peritoneal metastasis in non-serosa-invasive gastric cancer: a retrospective study of a prospectively-collected database. BMC Cancer. 2013;13:57.CrossRefPubMedCentralPubMed
26.
Marutsuka T, Shimada S, Shiomori K, Hayashi N, Yagi Y, Yamane T, et al. Mechanisms of peritoneal metastasis after operation for non-serosa-invasive gastric carcinoma: an ultrarapid detection system for intraperitoneal free cancer cells and a prophylactic strategy for peritoneal metastasis. Clin Cancer Res. 2003;9:678–85.PubMed
Metadata
Title
Intraoperative dissemination during gastrectomy for gastric cancer associated with serosal invasion
Authors
Yukio Tokumitsu
Shigefumi Yoshino
Michihisa Iida
Kiyoshi Yoshimura
Tomio Ueno
Shoichi Hazama
Masaaki Oka
Publication date
01-06-2015
Publisher
Springer Japan
Published in
Surgery Today / Issue 6/2015
Print ISSN: 0941-1291
Electronic ISSN: 1436-2813
DOI
https://doi.org/10.1007/s00595-014-1005-2

Other articles of this Issue 6/2015

Surgery Today 6/2015 Go to the issue

Case Report

Cronkhite–Canada syndrome associated with esophageal and gastric cancers: report of a case

Review Article

Small-for-size syndrome in living-donor liver transplantation using a left lobe graft

Case Report

Laparoscopic distal gastrectomy for pyloric stenosis caused by heterotopic glands in a young female: report of a case

Original Article

A propensity score-matching analysis comparing the oncological outcomes of laparoscopic and open surgery in patients with Stage I/II colon and upper rectal cancers

Original Article

Macrophage density and macrophage colony-stimulating factor expression predict the postoperative prognosis in patients with intrahepatic cholangiocarcinoma

Case Report

Single-incision laparoscopic rectopexy (Wells) with simultaneous sigmoidectomy in a case of complete rectal prolapse and a sigmoid tumor: report of a case