Intraoperative lavage for cytological examination in 1,297 patients with gastric carcinoma

BACKGROUND: This study examined the clinical value of intraoperative perito neal lavage for cytological examination in patients with gastric cancer. Pe ritoneal dissemination is the most frequent mode of recurrence for this tum or. METHODS: A retrospective of lavage findings, other factors, and outcome was performed in 1,297 patients with gastric cancer who underwent intraoperati ve peritoneal lavage. RESULTS: The 5-year survival rate of patients with positive ravage cytology was only 2%. Patients who underwent curative resection and had negative cy tology had a significantly better 5-year survival rate (P < 0.001). Even am ong patients with macroscopic peritoneal dissemination, the survival rate w as significantly better with negative cytology, which reflected fewer free cancer cells in the peritoneal cavity. Serum concentrations of carcinoembry onic antigen and carbohydrate antigen 19-9 were significantly higher in pat ients with positive cytology. Multivariate analyses indicated that intraope rative cytological findings was an independent prognostic factor for surviv al, and was the most important factor for predicting peritoneal recurrence. CONCLUSIONS: Intraoperative peritoneal lavage cytology is important in pred icting survival and peritoneal recurrence in gastric cancer. (C) 1999 by Ex cerpta Medica, Inc.