Annals of Coloproctology

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Original Article

Role of Peritoneal Lavage Cytology and Prediction of Prognosis and Peritoneal Recurrence After Curative Surgery for Colorectal Cancer: Sung Joon Bae, Ui Sup Shin, Young-Jun Ki, Sang Sik Cho, Sun Mi Moon, Sun Hoo Park; Ann Coloproctol. 2014;30(6):266-273. Published online December 31, 2014; DOI: https://doi.org/10.3393/ac.2014.30.6.266

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13 Web of Science
12 Citations

Purpose

In colorectal cancer, the role of detecting free malignant cells from peritoneal lavage is currently unclear. In this study, we investigated the positive rate of free malignant cells in peritoneal lavage fluid and their predictive value for prognosis and peritoneal recurrence after a curative resection.

Methods

From October 2009 to December 2011, in a prospective manner, we performed cytologic examinations of peritoneal lavage fluid obtained just after the abdominal incision from 145 patients who underwent curative surgery for colorectal cancer. We used proportional hazard regression models to analyze the predictive role of positive cytology for peritoneal recurrence and survival.

Results

Among total 145 patients, six patients (4.1%) showed positive cytology. During the median follow-up of 32 months (range, 8-49 months), 27 patients (18.6%) developed recurrence. Among them, 5 patients (3.4%) showed peritoneal carcinomatosis. In the multivariate analysis, positive cytology was an independent predictive factor for peritoneal recurrence (hazard ratio [HR], 136.5; 95% confidence interval [CI], 12.2-1,531.9; P < 0.0001) and an independent poor prognostic factor for overall survival (HR, 11.4; 95% CI, 1.8-72.0; P = 0.009) and for disease-free survival (HR, 11.1; 95% CI, 3.4-35.8; P < 0.0001).

Conclusion

Positive cytology of peritoneal fluid was significantly associated with peritoneal recurrence and worse survival in patients undergoing curative surgery for colorectal cancer. Peritoneal cytology might be a useful tool for selecting patients who need intraperitoneal or systemic chemotherapy.

Citations

Citations to this article as recorded by

Intraoperative flow cytometry in detecting free carcinoma cells in peritoneal lavage fluid of gastric carcinoma cases
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Cytometry Part B: Clinical Cytometry.2025;[Epub] CrossRef
Peritoneal Lavage Cytology Predicts Peritoneal Metastasis and is Associated with Poor Prognosis in Patients with Stage II–III Colorectal Cancer
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Conventional peritoneal cytology lacks the prognostic significance of detecting local or peritoneal recurrence in colorectal cancer: An Egyptian experience
Mohamed Shalaby, Tarek S El Baradie, Mohamed Salama, Hebat A M Shaaban, Rasha M Allam, Ehab O.A. Hafiz, Mohamed Aly Abdelhamed, Amr Attia
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Interleukin 10 level in the peritoneal cavity is a prognostic marker for peritoneal recurrence of T4 colorectal cancer
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Scientific Reports.2021;[Epub] CrossRef
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World Journal of Gastroenterology.2016; 22(34): 7692. CrossRef
The preoperative platelet to lymphocyte ratio is a prognostic marker in patients with stage II colorectal cancer
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Intraoperative Peritoneal Lavage: Limitations of Current Evidence for Clinical Implementation
Duck-Woo Kim
Annals of Coloproctology.2014; 30(6): 248. CrossRef

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