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Published in: Surgery Today 6/2014

01-06-2014 | Original Article

Positive peritoneal washing cytology is a potential risk factor for the recurrence of curatively resected colorectal cancer

Authors: Yoichiro Homma, Takashi Hamano, Yasuhiro Akazawa, Yoshiro Otsuki, Shinichi Shimizu, Hiroshi Kobayashi, Shingo Kameoka, Yasuyuki Kobayashi

Published in: Surgery Today | Issue 6/2014

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Abstract

Purposes

Whether free peritoneal cancer cells should be considered peritoneal dissemination in colorectal cancer patients remains controversial. The aim of this study was to investigate the clinical significance of positive peritoneal washing cytology (PWC) in patients with colorectal cancer.

Methods

We retrospectively analyzed the records of 771 sequential patients diagnosed with stage 0–III colorectal cancer who underwent R0 resection and had no distant metastases or peritoneal dissemination.

Results

PWC was performed on all 771 patients. Sixty-eight patients experienced metastasis recurrence, 10 of whom experienced peritoneal recurrence. Of the 10 patients with peritoneal recurrence, 6 had positive PWC. Out of the 771 patients, 21 had positive PWC. Of these 21 patients, 6 had peritoneal recurrence, while 4 had distant metastasis and no peritoneal recurrence during the observation period. The 5-year disease-free survival was 89.0 % in the patients with negative PWC vs. 46.8 % in the patients with positive PWC (p < 0.0001, log-rank test). A Cox proportional hazards model revealed that positive PWC was the strongest independent risk factor for cancer-specific recurrence.

Conclusions

Our study highlights PWC as a useful prognostic tool in patients undergoing curative surgery for colorectal cancer, since positive PWC was shown to be a potential risk factor for recurrence.
Literature
1.
go back to reference La Torre M, Rossi Del Monte S, Ferri M, Cosenza G, Mercantini P, Ziparo V. Peritoneal washing cytology in gastric cancer. How, when and who will get a benefit? A review. Minerva Gastroenterol Dietol. 2011;57:43–51.PubMed La Torre M, Rossi Del Monte S, Ferri M, Cosenza G, Mercantini P, Ziparo V. Peritoneal washing cytology in gastric cancer. How, when and who will get a benefit? A review. Minerva Gastroenterol Dietol. 2011;57:43–51.PubMed
2.
go back to reference Japanese Gastric Cancer Association. Japanese Classification of Gastric Carcinoma, 2nd English edition. Gastric Cancer. 1998;1:10–24.PubMedCrossRef Japanese Gastric Cancer Association. Japanese Classification of Gastric Carcinoma, 2nd English edition. Gastric Cancer. 1998;1:10–24.PubMedCrossRef
3.
go back to reference Wind P, Norklinger B, Roger V, Kahlil A, Guin E, Parc R. Long-term prognostic value of positive peritoneal washing in colon cancer. Scand J Gastroenterol. 1999;34:606–10.PubMedCrossRef Wind P, Norklinger B, Roger V, Kahlil A, Guin E, Parc R. Long-term prognostic value of positive peritoneal washing in colon cancer. Scand J Gastroenterol. 1999;34:606–10.PubMedCrossRef
4.
go back to reference Kanellos I, Demetriades H, Zintzaras E, Mandrali A, Mantzoros I, Betsis D. Incidence and prognostic value of positive peritoneal cytology in colorectal cancer. Dis Colon Rectum. 2003;46:535–9.PubMedCrossRef Kanellos I, Demetriades H, Zintzaras E, Mandrali A, Mantzoros I, Betsis D. Incidence and prognostic value of positive peritoneal cytology in colorectal cancer. Dis Colon Rectum. 2003;46:535–9.PubMedCrossRef
5.
go back to reference Hara M, Nakanishi H, Jun Q, Kanemitsu Y, Ito S, Mochizuki Y, et al. Comparative analysis of intraperitoneal minimal free cancer cells between colorectal and gastric cancer patients using quantitative RT-PCR: possible reason for rare peritoneal recurrence in colorectal cancer. Clin Exp Metastasis. 2007;24:179–89.PubMedCrossRef Hara M, Nakanishi H, Jun Q, Kanemitsu Y, Ito S, Mochizuki Y, et al. Comparative analysis of intraperitoneal minimal free cancer cells between colorectal and gastric cancer patients using quantitative RT-PCR: possible reason for rare peritoneal recurrence in colorectal cancer. Clin Exp Metastasis. 2007;24:179–89.PubMedCrossRef
6.
go back to reference Kitai T, Kawashima M, Yamanaka K, Ichijima K, Fujii H, Mashima S, et al. Cytoreductive surgery with intraperitoneal chemotherapy to treat pseudomyxoma peritonei at nonspecialized hospitals. Surg Today. 2011;41:1219–23.PubMedCrossRef Kitai T, Kawashima M, Yamanaka K, Ichijima K, Fujii H, Mashima S, et al. Cytoreductive surgery with intraperitoneal chemotherapy to treat pseudomyxoma peritonei at nonspecialized hospitals. Surg Today. 2011;41:1219–23.PubMedCrossRef
7.
go back to reference 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.PubMedCrossRef 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.PubMedCrossRef
8.
go back to reference Hamano T, Homma Y, Otsuki Y, Shimizu S, Kobayashi H, Kobayashi Y. Inguinal lymph node metastases are recognized with high frequency in rectal adenocarcinoma invading the dentate line. The histological features at the invasive front may predict inguinal lymph node metastasis. Colorectal Dis. 2010;12:e200–5.PubMedCrossRef Hamano T, Homma Y, Otsuki Y, Shimizu S, Kobayashi H, Kobayashi Y. Inguinal lymph node metastases are recognized with high frequency in rectal adenocarcinoma invading the dentate line. The histological features at the invasive front may predict inguinal lymph node metastasis. Colorectal Dis. 2010;12:e200–5.PubMedCrossRef
9.
go back to reference Kobayashi H, Mochizuki H, Sugihara K, Morita T, Kotake K, Teramoto T, et al. Characteristics of recurrence and surveillance tools after curative resection for colorectal cancer: a multicenter study. Surgery. 2007;141:67–75.PubMedCrossRef Kobayashi H, Mochizuki H, Sugihara K, Morita T, Kotake K, Teramoto T, et al. Characteristics of recurrence and surveillance tools after curative resection for colorectal cancer: a multicenter study. Surgery. 2007;141:67–75.PubMedCrossRef
10.
go back to reference NIH consensus conference. Adjuvant therapy for patients with colon and rectal cancer. JAMA. 1990;264:1444–50.CrossRef NIH consensus conference. Adjuvant therapy for patients with colon and rectal cancer. JAMA. 1990;264:1444–50.CrossRef
11.
go back to reference Nakfoor BM, Willett CG, Shellito PC, Kaufman DS, Daly WJ. The impact of 5-fluorouracil and intraoperative electron beam radiation therapy on the outcome of patients with locally advanced primary rectal and rectosigmoid cancer. Ann Surg. 1998;228:194–200.PubMedCentralPubMedCrossRef Nakfoor BM, Willett CG, Shellito PC, Kaufman DS, Daly WJ. The impact of 5-fluorouracil and intraoperative electron beam radiation therapy on the outcome of patients with locally advanced primary rectal and rectosigmoid cancer. Ann Surg. 1998;228:194–200.PubMedCentralPubMedCrossRef
12.
go back to reference Hashiguchi Y, Hase K, Kotake K, Ueno H, Shinto E, Mochizuki H et al. Evaluation of the TNM 7th edition for colon cancer in two Nationwide Registries of the United States and Japan. Colorectal Dis. 2012;14(9):1065–74. doi:10.1111/j.1463-1318.2011.02917.x. Hashiguchi Y, Hase K, Kotake K, Ueno H, Shinto E, Mochizuki H et al. Evaluation of the TNM 7th edition for colon cancer in two Nationwide Registries of the United States and Japan. Colorectal Dis. 2012;14(9):1065–74. doi:10.​1111/​j.​1463-1318.​2011.​02917.​x.
13.
go back to reference Noura S, Ohue M, Seki Y, Yano M, Ishikawa O, Kameyama M. Long-term prognostic value of conventional peritoneal lavage cytology in patients undergoing curative colorectal cancer resection. Dis Colon Rectum. 2009;52:1312–20.PubMedCrossRef Noura S, Ohue M, Seki Y, Yano M, Ishikawa O, Kameyama M. Long-term prognostic value of conventional peritoneal lavage cytology in patients undergoing curative colorectal cancer resection. Dis Colon Rectum. 2009;52:1312–20.PubMedCrossRef
14.
go back to reference Anastasiadis PG, Romanidis KN, Polichronidis A, Koutlaki NG, Tamiolakis D, Simopoulos K. The contribution of rapid intraoperative cytology to the improvement of ovarian cancer staging. Gynecol Oncol. 2002;86:244–9.PubMedCrossRef Anastasiadis PG, Romanidis KN, Polichronidis A, Koutlaki NG, Tamiolakis D, Simopoulos K. The contribution of rapid intraoperative cytology to the improvement of ovarian cancer staging. Gynecol Oncol. 2002;86:244–9.PubMedCrossRef
15.
go back to reference Yang SH, Lin JK, Lai CR, Chen CC, Li AF, Liang WY, et al. Risk factors for peritoneal dissemination of colorectal cancer. J Surg Oncol. 2004;87:167–73.PubMedCrossRef Yang SH, Lin JK, Lai CR, Chen CC, Li AF, Liang WY, et al. Risk factors for peritoneal dissemination of colorectal cancer. J Surg Oncol. 2004;87:167–73.PubMedCrossRef
16.
go back to reference 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 72:60–64 (discussion 64–65). 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 72:60–64 (discussion 64–65).
17.
go back to reference Lee IK, Kim do H, Gorden DL, Lee YS, Sung NY, Park GS, et al. Prognostic value of CEA and CA 19-9 tumor markers combined with cytology from peritoneal fluid in colorectal cancer. Ann Surg Oncol. 2009;16:861–70.PubMedCrossRef Lee IK, Kim do H, Gorden DL, Lee YS, Sung NY, Park GS, et al. Prognostic value of CEA and CA 19-9 tumor markers combined with cytology from peritoneal fluid in colorectal cancer. Ann Surg Oncol. 2009;16:861–70.PubMedCrossRef
18.
go back to reference Benson AB 3rd, Schrag D, Somerfield MR, Cohen AM, Figueredo AT, Flynn PJ, et al. American Society of Clinical Oncology recommendations on adjuvant chemotherapy for stage II colon cancer. J Clin Oncol. 2004;22:3408–19.PubMedCrossRef Benson AB 3rd, Schrag D, Somerfield MR, Cohen AM, Figueredo AT, Flynn PJ, et al. American Society of Clinical Oncology recommendations on adjuvant chemotherapy for stage II colon cancer. J Clin Oncol. 2004;22:3408–19.PubMedCrossRef
19.
go back to reference Engstrom PF, Arnoletti JP, Benson AB 3rd, Chen YJ, Choti MA, Cooper HS, et al. NCCN Clinical Practice Guidelines in Oncology: rectal cancer. J Natl Compr Canc Netw. 2009;7:838–81.PubMed Engstrom PF, Arnoletti JP, Benson AB 3rd, Chen YJ, Choti MA, Cooper HS, et al. NCCN Clinical Practice Guidelines in Oncology: rectal cancer. J Natl Compr Canc Netw. 2009;7:838–81.PubMed
20.
go back to reference Engstrom PF, Arnoletti JP, Benson AB 3rd, Chen YJ, Choti MA, Cooper HS, et al. NCCN Clinical Practice Guidelines in Oncology: colon cancer. J Natl Compr Canc Netw. 2009;7:778–831.PubMed Engstrom PF, Arnoletti JP, Benson AB 3rd, Chen YJ, Choti MA, Cooper HS, et al. NCCN Clinical Practice Guidelines in Oncology: colon cancer. J Natl Compr Canc Netw. 2009;7:778–831.PubMed
Metadata
Title
Positive peritoneal washing cytology is a potential risk factor for the recurrence of curatively resected colorectal cancer
Authors
Yoichiro Homma
Takashi Hamano
Yasuhiro Akazawa
Yoshiro Otsuki
Shinichi Shimizu
Hiroshi Kobayashi
Shingo Kameoka
Yasuyuki Kobayashi
Publication date
01-06-2014
Publisher
Springer Japan
Published in
Surgery Today / Issue 6/2014
Print ISSN: 0941-1291
Electronic ISSN: 1436-2813
DOI
https://doi.org/10.1007/s00595-013-0689-z

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