Prognostic importance of peritoneal washing cytology in patients with otherwise resectable pancreatic ductal adenocarcinoma who underwent pancreatectomy

A nationwide, cancer registry–based study from the Japan Pancreas Society

Committee of Clinical Research, Japan Pancreas Society

Research output: Contribution to journalArticle

Abstract

Background: The importance of peritoneal washing cytology status both as a sign of irresectability and as a prognostic factor for pancreatic ductal adenocarcinoma remains controversial. The purpose of this nationwide, cancer registry–based study was to clarify the clinical implications of operative resection in patients who had positive cytology status. Methods: Clinical data from 1,970 patients who underwent tumor resection were collected from the Pancreatic Cancer Registry in Japan. Clinicopathologic factors and overall survival curves were analyzed, and multivariate Cox proportional hazard models were evaluated. Results: Among the 1,970 patients analyzed, positive cytology status was found in 106 patients and negative cytology status was found in 1,864 patients. The positive cytology status group had a greater frequency of pancreatic body and tail cancer and greater preoperative serum carbohydrate antigen 19-9 levels than the negative cytology status group (P < .001 each). The ratio of peritoneal recurrence tended to be greater in the positive cytology status group (14% vs 43%; P < .001). Overall median survival times were less in the positive cytology status group (17.5 months vs 29.4 months; P < .001). The 5-year survival rates were 13.7% and 31.1% in the positive cytology status and negative cytology status groups, respectively. Multivariate analysis of positive cytology status patients revealed that adjuvant chemotherapy was an independent prognostic factor. Conclusion: Positive cytology status was an adverse prognostic factor in patients who underwent resection for pancreatic ductal adenocarcinoma but did not preclude attempted curative resection. Curative resection followed by adjuvant chemotherapy may contribute to long-term prognosis in patients with positive cytology status.

Original languageEnglish
JournalSurgery (United States)
DOIs
Publication statusAccepted/In press - Jan 1 2019

Fingerprint

Pancreatectomy
Cell Biology
Pancreas
Japan
Adenocarcinoma
Neoplasms
Adjuvant Chemotherapy
Survival
Pancreatic Neoplasms
Proportional Hazards Models
Registries

All Science Journal Classification (ASJC) codes

  • Surgery

Cite this

@article{2bab33929d24414691c4267f9b068a1a,
title = "Prognostic importance of peritoneal washing cytology in patients with otherwise resectable pancreatic ductal adenocarcinoma who underwent pancreatectomy: A nationwide, cancer registry–based study from the Japan Pancreas Society",
abstract = "Background: The importance of peritoneal washing cytology status both as a sign of irresectability and as a prognostic factor for pancreatic ductal adenocarcinoma remains controversial. The purpose of this nationwide, cancer registry–based study was to clarify the clinical implications of operative resection in patients who had positive cytology status. Methods: Clinical data from 1,970 patients who underwent tumor resection were collected from the Pancreatic Cancer Registry in Japan. Clinicopathologic factors and overall survival curves were analyzed, and multivariate Cox proportional hazard models were evaluated. Results: Among the 1,970 patients analyzed, positive cytology status was found in 106 patients and negative cytology status was found in 1,864 patients. The positive cytology status group had a greater frequency of pancreatic body and tail cancer and greater preoperative serum carbohydrate antigen 19-9 levels than the negative cytology status group (P < .001 each). The ratio of peritoneal recurrence tended to be greater in the positive cytology status group (14{\%} vs 43{\%}; P < .001). Overall median survival times were less in the positive cytology status group (17.5 months vs 29.4 months; P < .001). The 5-year survival rates were 13.7{\%} and 31.1{\%} in the positive cytology status and negative cytology status groups, respectively. Multivariate analysis of positive cytology status patients revealed that adjuvant chemotherapy was an independent prognostic factor. Conclusion: Positive cytology status was an adverse prognostic factor in patients who underwent resection for pancreatic ductal adenocarcinoma but did not preclude attempted curative resection. Curative resection followed by adjuvant chemotherapy may contribute to long-term prognosis in patients with positive cytology status.",
author = "{Committee of Clinical Research, Japan Pancreas Society} and Hiroyoshi Tsuchida and Tsutomu Fujii and Masamichi Mizuma and S. Satoi and Hisato Igarashi and Hidetoshi Eguchi and Tamotsu Kuroki and Yasuhiro Shimizu and Masaji Tani and Satoshi Tanno and Yoshihisa Tsuji and Yoshiki Hirooka and Atsushi Masamune and Kazuhiro Mizumoto and T. Itoi and Shinichi Egawa and Yuzo Kodama and Shin Hamada and Michiaki Unno and Hiroki Yamaue and Kazuichi Okazaki",
year = "2019",
month = "1",
day = "1",
doi = "10.1016/j.surg.2019.06.023",
language = "English",
journal = "Surgery",
issn = "0039-6060",
publisher = "Mosby Inc.",

}

TY - JOUR

T1 - Prognostic importance of peritoneal washing cytology in patients with otherwise resectable pancreatic ductal adenocarcinoma who underwent pancreatectomy

T2 - A nationwide, cancer registry–based study from the Japan Pancreas Society

AU - Committee of Clinical Research, Japan Pancreas Society

AU - Tsuchida, Hiroyoshi

AU - Fujii, Tsutomu

AU - Mizuma, Masamichi

AU - Satoi, S.

AU - Igarashi, Hisato

AU - Eguchi, Hidetoshi

AU - Kuroki, Tamotsu

AU - Shimizu, Yasuhiro

AU - Tani, Masaji

AU - Tanno, Satoshi

AU - Tsuji, Yoshihisa

AU - Hirooka, Yoshiki

AU - Masamune, Atsushi

AU - Mizumoto, Kazuhiro

AU - Itoi, T.

AU - Egawa, Shinichi

AU - Kodama, Yuzo

AU - Hamada, Shin

AU - Unno, Michiaki

AU - Yamaue, Hiroki

AU - Okazaki, Kazuichi

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Background: The importance of peritoneal washing cytology status both as a sign of irresectability and as a prognostic factor for pancreatic ductal adenocarcinoma remains controversial. The purpose of this nationwide, cancer registry–based study was to clarify the clinical implications of operative resection in patients who had positive cytology status. Methods: Clinical data from 1,970 patients who underwent tumor resection were collected from the Pancreatic Cancer Registry in Japan. Clinicopathologic factors and overall survival curves were analyzed, and multivariate Cox proportional hazard models were evaluated. Results: Among the 1,970 patients analyzed, positive cytology status was found in 106 patients and negative cytology status was found in 1,864 patients. The positive cytology status group had a greater frequency of pancreatic body and tail cancer and greater preoperative serum carbohydrate antigen 19-9 levels than the negative cytology status group (P < .001 each). The ratio of peritoneal recurrence tended to be greater in the positive cytology status group (14% vs 43%; P < .001). Overall median survival times were less in the positive cytology status group (17.5 months vs 29.4 months; P < .001). The 5-year survival rates were 13.7% and 31.1% in the positive cytology status and negative cytology status groups, respectively. Multivariate analysis of positive cytology status patients revealed that adjuvant chemotherapy was an independent prognostic factor. Conclusion: Positive cytology status was an adverse prognostic factor in patients who underwent resection for pancreatic ductal adenocarcinoma but did not preclude attempted curative resection. Curative resection followed by adjuvant chemotherapy may contribute to long-term prognosis in patients with positive cytology status.

AB - Background: The importance of peritoneal washing cytology status both as a sign of irresectability and as a prognostic factor for pancreatic ductal adenocarcinoma remains controversial. The purpose of this nationwide, cancer registry–based study was to clarify the clinical implications of operative resection in patients who had positive cytology status. Methods: Clinical data from 1,970 patients who underwent tumor resection were collected from the Pancreatic Cancer Registry in Japan. Clinicopathologic factors and overall survival curves were analyzed, and multivariate Cox proportional hazard models were evaluated. Results: Among the 1,970 patients analyzed, positive cytology status was found in 106 patients and negative cytology status was found in 1,864 patients. The positive cytology status group had a greater frequency of pancreatic body and tail cancer and greater preoperative serum carbohydrate antigen 19-9 levels than the negative cytology status group (P < .001 each). The ratio of peritoneal recurrence tended to be greater in the positive cytology status group (14% vs 43%; P < .001). Overall median survival times were less in the positive cytology status group (17.5 months vs 29.4 months; P < .001). The 5-year survival rates were 13.7% and 31.1% in the positive cytology status and negative cytology status groups, respectively. Multivariate analysis of positive cytology status patients revealed that adjuvant chemotherapy was an independent prognostic factor. Conclusion: Positive cytology status was an adverse prognostic factor in patients who underwent resection for pancreatic ductal adenocarcinoma but did not preclude attempted curative resection. Curative resection followed by adjuvant chemotherapy may contribute to long-term prognosis in patients with positive cytology status.

UR - http://www.scopus.com/inward/record.url?scp=85070917643&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85070917643&partnerID=8YFLogxK

U2 - 10.1016/j.surg.2019.06.023

DO - 10.1016/j.surg.2019.06.023

M3 - Article

JO - Surgery

JF - Surgery

SN - 0039-6060

ER -