title: Reappraisal of peritoneal washing cytology in 984 patients with pancreatic ductal adenocarcinoma who underwent margin-negative resection.
abstract: OBJECTIVE
  The objective of the present study was to reappraise the clinical value of peritoneal washing cytology (CY) in 984 pancreatic ductal adenocarcinoma patients who underwent margin-negative resection.
  
  
  METHODS
  In a 2001-2011 database from seven high-volume surgical institutions in Japan, 69 patients (7%) had positive CY (CY+ group) indicative of M1 disease and 915 patients had negative CY (CY- group). Clinicopathological data and survival were compared between groups.
  
  
  RESULTS
  Significant correlations between CY+ and high CA19-9 level, pancreatic body and tail cancer, lymph node metastasis, and a lower frequency of R0 resection were observed. Overall survival (OS) of CY+ patients was significantly worse than that of CY- patients (median survival time [MST], 16 vs. 25 months; 3-year OS rate, 6 vs. 37%; p < 0.001). CY+ patients had a significantly higher rate of post-operative peritoneal carcinomatosis than CY- patients (48 vs. 21%; p < 0.001). Administration of adjuvant chemotherapy did not provide a favorable survival outcome to CY+ patients. The current study showed that patients with M1 disease had acceptable MST after margin-negative resection and a high incidence of peritoneal carcinomatosis within 3 years after surgery, resulting in decreased long-term survival. The development of a new strategy to control peritoneal carcinomatosis when surgical resection is performed in such patients is required.
authors.affiliation: Department of Surgery, Kansai Medical University, Osaka, Japan.
authors.forename: Sohei
authors.initials: S
authors.lastname: Satoi
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Murakami
authors.forename: Fuyuhiko
authors.initials: F
authors.lastname: Motoi
authors.forename: Kenichiro
authors.initials: K
authors.lastname: Uemura
authors.forename: Manabu
authors.initials: M
authors.lastname: Kawai
authors.forename: Masanao
authors.initials: M
authors.lastname: Kurata
authors.forename: Masayuki
authors.initials: M
authors.lastname: Sho
authors.forename: Ippei
authors.initials: I
authors.lastname: Matsumoto
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Yanagimoto
authors.forename: Tomohisa
authors.initials: T
authors.lastname: Yamamoto
authors.forename: Masamichi
authors.initials: M
authors.lastname: Mizuma
authors.forename: Michiaki
authors.initials: M
authors.lastname: Unno
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Hashimoto
authors.forename: Seiko
authors.initials: S
authors.lastname: Hirono
authors.forename: Hiroki
authors.initials: H
authors.lastname: Yamaue
authors.forename: Goro
authors.initials: G
authors.lastname: Honda
authors.forename: Minako
authors.initials: M
authors.lastname: Nagai
authors.forename: Yoshiyuki
authors.initials: Y
authors.lastname: Nakajima
authors.forename: Makoto
authors.initials: M
authors.lastname: Shinzeki
authors.forename: Takumi
authors.initials: T
authors.lastname: Fukumoto
authors.forename: A-Hon
authors.initials: AH
authors.lastname: Kwon
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D021441:Carcinoma, Pancreatic Ductal / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D010180:Pancreatectomy / Q000379:methods*; D010190:Pancreatic Neoplasms / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D010537:Peritoneum / Q000473:pathology*; D012189:Retrospective Studies; D015996:Survival Rate / Q000639:trends