PROGNOSTIC VALUE OF POSITIVE CYTOLOGY FINDINGS FROM ABDOMINAL WASHINGS IN PATIENTS WITH GASTRIC-CANCER

The poor prognosis of patients with gastric cancer with free abdominal tumour cells on cytological examination has been described in Japan. In a randomized trial in the Netherlands comparing D1 and D2 lymphaden ectomy for gastric cancer, patients were subjected to cytological exam ination of abdominal washings on an optional basis; findings were of n o consequence for scheduled treatment. Cytology results in 535 patient s were obtained, in 457 (85.4 per cent) after curative resection and i n 78 (14.6 per cent) after palliative operation. There was a clear ass ociation of positive cytology results with serosal invasion (12 per ce nt positive cytology) and lymph node infiltration (7.5 per cent positi ve cytology). Survival of those with positive cytology results was sig nificantly lower than that of those with negative findings, irrespecti ve of the procedure employed (curative or palliative). Cytological exa mination of abdominal washings increases the accuracy of staging and i mproves the selection of patients suitable for curative or palliative resection.