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Meszoely IM , Lee JS , Watson JC , Meyers M , Wang H , Hoffman JP
Peritoneal cytology in patients with potentially resectable adenocarcinoma of the pancreas
American Surgeon. 2004 Mar;70(3) :208-213
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The prognostic significance of malignant cells in the peritoneal washings of patients with pancreatic adenocarcinoma remains poorly defined. Prior reports suggest that positive peritoneal cytology (PPC) is associated with advanced disease and reduced survival. To determine the prognostic value of PPC in patients with pancreatic cancer, we retrospectively reviewed our database between July 1987 and September 2002 and identified 168 patients who had undergone exploration for potentially resectable pancreatic cancer with peritoneal washings performed at the time of exploration. One hundred thirty-five patients underwent resection; 33 were considered unresectable. PPC was reported for 27 patients (16.1%): 13 (9.6%) in the resected and 14 (42.4%) in the unresected group. Median time to macroscopically detected recurrence in the resected group was not significantly different in the PPC versus negative peritoneal cytology (NPC) patients (10 vs 12 months, P = 0.46). Median overall s! urvival of patients with PPC versus NPC approached, but did not reach, significance (15 vs 19 months, P = 0.055). Peritoneal cytology status was not associated with administration of chemoradiation, margin status, antecedent fine-needle aspiration, stage, or site of recurrence. These data suggest that malignant cells in peritoneal washings of patients with potentially resectable pancreatic adenocarcinoma should not preclude resection. Long-term survival may be achieved, therefore aggressive treatment should strongly be considered.
English Article KeyWords Plus: CANCER; CARCINOMA; HEAD; RESECTION; WASHINGS Hoffman, JP; *Fox* *Chase* Canc Ctr, Dept Surg, 333 Cottman Ave, Philadelphia, PA 19111 USA. Research Addresses: *Fox* *Chase* Canc Ctr, Dept Surg, Philadelphia, PA 19111 USA. *Fox* *Chase* Canc Ctr, Dept Biostat, Philadelphia, PA 19111 USA. Cited References: FERNANDEZDELCAS.C, 1995, BRIT J SURG, V82, P1127 FREENY PC, 1993, AM J SURG, V165, P600 GRIFFIN JF, 1990, CANCER, V66, P56 GRIMSHAW RN, 1990, GYNECOL ONCOL, V36, P97 JEMAL A, 2002, CA-CANCER J CLIN, V52, P23 JIMENEZ RE, 2000, J HEPATOBILIARY PANC, V7, P15 JIMENEZ RE, 2000, ARCH SURG-CHICAGO, V135, P409 KIENLE P, 2002, DIGEST SURG, V19, P453 LEACH SD, 1995, SURGERY, V118, P472 LEI SZ, 1994, ARCH SURG-CHICAGO, V129, P639 MAKARY MA, 1998, ARCH SURG-CHICAGO, V133, P361 MARTIN JK, 1986, MAYO CLIN PROC, V61, P467 MERCHANT NB, 1999, J AM COLL SURGEONS, V188, P421 NAKAO A, 1999, HEPATO-GASTROENTEROL, V46, P2974 WARSHAW AL, 1991, AM J SURG, V161, P26 WILLETT CG, 1993, ANN SURG, V217, P144 YACHIDA S, 2002, BRIT J SURG, V89, P573 YEO CJ, 1995, ANN SURG, V221, P721 Number of cited references: 18 Number of times cited: 0 Publisher: SOUTHEASTERN SURGICAL CONGRESS; 141 WEST WIEUCA RD, STE B100, ATLANTA, GA 30342 USA. 0003-1348