title: Positive Intraoperative Peritoneal Lavage Cytology is a Negative Prognostic Factor in Pancreatic Ductal Adenocarcinoma: A Retrospective Single-Center Study.
abstract: OBJECTIVE
  The aim of this study is to evaluate the prognostic significance of intraoperative peritoneal lavage cytology (PLC) in pancreatic invasive ductal adenocarcinoma.
  
  
  METHODS
  Intraoperative PLC was evaluated in 162 patients with resectable pancreatic invasive ductal adenocarcinoma. The results were analyzed for correlations with clinicopathological parameters and/or prognoses.
  
  
  RESULTS
  In the 162 cases of resectable pancreatic ductal adenocarcinoma, 18 (11%), 141 (87%), and 3 (2%) were positive, negative, and equivocal for intraoperative PLC, respectively. Intraoperative PLC positivity was associated with older patients (over 65 years), large tumor size (over 35 mm), tumor location in the body/tail of the pancreas, and distant metastasis. Univariate analysis showed that larger tumor sizes (≥35 mm, P = 0.001), lymph node metastases (P = 0.005), distant metastasis (P = 0.004), advanced stage (stage IIB or III, P = 0.006), advanced tumor histological grade (G3, P < 0.001), or positive intraoperative PLC (P = 0.002) are associated with a shorter survival. Multivariate analysis revealed that larger tumor sizes (≥35 mm, P = 0.026), lymph node metastasis (P = 0.021), advanced tumor histological grade (G3, P < 0.001), and positive intraoperative PLC (P = 0.002) were independent prognostic factors.
  
  
  CONCLUSIONS
  Intraoperative PLC is an independent prognostic factor for resectable pancreatic invasive ductal adenocarcinoma.
authors: Department of Pathology, Tokai University School of Medicine , Isehara , Japan.
authors: Kenichi
authors: K
authors: Hirabayashi
authors: Department of Pathology, Tokai University School of Medicine , Isehara , Japan.
authors: Akiko
authors: A
authors: Imoto
authors: Department of Surgery, Tokai University School of Medicine , Isehara , Japan.
authors: Misuzu
authors: M
authors: Yamada
authors: Department of Gastroenterology and Hepatology, Tokai University School of Medicine , Isehara , Japan.
authors: Atsuko
authors: A
authors: Hadano
authors: Division of Diagnostic Pathology, Tokai University Hospital , Isehara , Japan.
authors: Nobuaki
authors: N
authors: Kato
authors: Division of Diagnostic Pathology, Tokai University Hospital , Isehara , Japan.
authors: Youko
authors: Y
authors: Miyajima
authors: Division of Diagnostic Pathology, Tokai University Hospital , Isehara , Japan.
authors: Hitoshi
authors: H
authors: Ito
authors: Department of Gastroenterology and Hepatology, Tokai University School of Medicine , Isehara , Japan.
authors: Yoshiaki
authors: Y
authors: Kawaguchi
authors: Department of Surgery, Tokai University School of Medicine , Isehara , Japan.
authors: Toshio
authors: T
authors: Nakagohri
authors: Department of Gastroenterology and Hepatology, Tokai University School of Medicine , Isehara , Japan.
authors: Tetsuya
authors: T
authors: Mine
authors: Department of Pathology, Tokai University School of Medicine , Isehara , Japan.
authors: Naoya
authors: N
authors: Nakamura
keywords: adenocarcinoma; ascites; cytology; pancreatic cancer; peritoneal lavage; survival analysis