title: Presence of free cancer cells in the peritoneal cavity of patients who underwent curative gastrectomy with lymph node dissection.
abstract: OBJECTIVE
  The aim of this study was to determine the ratio of patients with positive peritoneal cytology who underwent radical gastrectomy for gastric cancer, to evaluate the factors effecting risk of positive cytology and to analyze the effects cytology findings on survival.
  
  
  METHODS
  Peritoneal lavage samples were obtained from 255 patients who underwent radical gastrectomy with D2 (184 patients) or D3 (71 patients) lymph node dissection between January 2000 and December 2007.
  
  
  RESULTS
  Thirty-six (14.1%) of 255 patients had free cancer cells in the wash cytology samples. T stage (T4) and differentiation were found to be independent risk factors for positive peritoneal cytology in multivariate analysis. Survival rate of cytology negative patients was significantly higher, however cytology findings were not found to be an independent prognostic factor for survival. T stage, lymph node metastasis and Borrmann classification (Borrmann type 4) appeared to be independent prognostic factors for survival in multivariate analyses.
  
  
  CONCLUSIONS
  Peritoneal cytology does not provide additional information according to the TNM (1997) staging system. However, it should be employed intraoperatively before potentially curable serosa involved gastric carcinomas, especially for T4 tumors. Surgery alone will not be enough for patients with positive cytology and further therapies should be employed.
authors.affiliation: Department of Gastroenterological Surgery, Turkiye Yuksek Ihtisas Teaching and Research Hospital, Ankara, Turkey.
authors.forename: Ilter
authors.initials: I
authors.lastname: Ozer
authors.forename: Erdal Birol
authors.initials: EB
authors.lastname: Bostanci
authors.forename: Tahsin
authors.initials: T
authors.lastname: Dalgic
authors.forename: Kerem
authors.initials: K
authors.lastname: Karaman
authors.forename: Murat
authors.initials: M
authors.lastname: Ulas
authors.forename: Yusuf Bayram
authors.initials: YB
authors.lastname: Ozogul
authors.forename: Metin
authors.initials: M
authors.lastname: Ercan
authors.forename: Cumhur
authors.initials: C
authors.lastname: Deger
authors.forename: Musa
authors.initials: M
authors.lastname: Akoglu
mesh_terms: D000368:Aged; D005260:Female; D005743:Gastrectomy; D006801:Humans; D053208:Kaplan-Meier Estimate; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D060787:Neoplasm Grading; D009367:Neoplasm Staging; D010529:Peritoneal Cavity / Q000473:pathology*; D010533:Peritoneal Lavage; D016016:Proportional Hazards Models; D012307:Risk Factors; D013274:Stomach Neoplasms / Q000473:pathology* / Q000601:surgery*