title: Lack of prognostic significance of conventional peritoneal cytology in colorectal and gastric cancers: results of EVOCAPE 2 multicentre prospective study.
abstract: OBJECTIVE
  In digestive cancers, the prognostic significance of intraperitoneal free cancer cells remains unclear (IPCC). The main objective of this study was to assess the prognostic significance of IPCC in colorectal and gastric adenocarcinoma. The secondary objectives were to evaluate the predictive significance of IPCC for the development of peritoneal carcinomatosis (PC) and to evaluate the prevalence of synchronous PC and IPCC.
  
  
  METHODS
  This was a prospective multicentre study. All patients undergoing surgery for a digestive tract cancer had peritoneal cytology taken. Patients with gastric and colorectal cancer with no residual tumour after surgery and no evidence of PC were followed-up for 2 years. The primary end point was overall survival.
  
  
  RESULTS
  Between 2002 and 2007, 1364 patients were enrolled and 956 were followed-up over 2 years. Prevalence of IPCC was 5.7% in colon cancer, 0.6% in rectal cancer and 19.5% in gastric cancer. The overall 2-year survival rate for patients with IPCC was 34.7% versus 86.8% for patients with negative cytology (p<0.0001). By multivariate analysis, IPCC was not an independent prognostic factor. No relationship between cytology and recurrence was found.
  
  
  CONCLUSIONS
  The presence of IPCC was not an independent prognostic and didn't add any additional prognostic information to the usual prognostic factors related to the tumour (pTNM and differentiation). Moreover the presence of IPCC detected with this method didn't appear to predict development of PC. Peritoneal cytology using conventional staining doesn't seem to be a useful tool for the staging of colorectal and gastric cancers.
authors.affiliation: Hospices civils de Lyon, Centre Hospitalier Lyon-Sud, Service de chirurgie viscérale et endocrinienne, 69495 Pierre-Bénite Cedex, France. eddy.cotte@chu-lyon.fr
authors.forename: E
authors.initials: E
authors.lastname: Cotte
authors.forename: P
authors.initials: P
authors.lastname: Peyrat
authors.forename: E
authors.initials: E
authors.lastname: Piaton
authors.forename: F
authors.initials: F
authors.lastname: Chapuis
authors.forename: M
authors.initials: M
authors.lastname: Rivoire
authors.forename: O
authors.initials: O
authors.lastname: Glehen
authors.forename: C
authors.initials: C
authors.lastname: Arvieux
authors.forename: J-Y
authors.initials: JY
authors.lastname: Mabrut
authors.forename: J
authors.initials: J
authors.lastname: Chipponi
authors.forename: F-N
authors.initials: FN
authors.lastname: Gilly
mesh_terms: D000230:Adenocarcinoma / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015179:Colorectal Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D016001:Confidence Intervals; D003581:Cytodiagnosis; D018572:Disease-Free Survival; D005260:Female; D005602:France; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local / Q000401:mortality / Q000473:pathology*; D009367:Neoplasm Staging; D009360:Neoplastic Cells, Circulating / Q000473:pathology*; D010533:Peritoneal Lavage; D010537:Peritoneum / Q000166:cytology / Q000473:pathology*; D011237:Predictive Value of Tests; D011379:Prognosis; D016016:Proportional Hazards Models; D011446:Prospective Studies; D018709:Statistics, Nonparametric; D013274:Stomach Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D016019:Survival Analysis; D013997:Time Factors; D055815:Young Adult