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01.09.2012 | Review Article

A systematic review of the accuracy and utility of peritoneal cytology in patients with gastric cancer

verfasst von: Pierre-Anthony Leake, Roberta Cardoso, Rajini Seevaratnam, Laercio Lourenco, Lucy Helyer, Alyson Mahar, Corwyn Rowsell, Natalie G. Coburn

Erschienen in: Gastric Cancer | Sonderheft 1/2012

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Abstract

Background

There is lack of uniformity in the utilization of peritoneal cytology in gastric cancer management. The identification of intraperitoneal free cancer cells (IFCCs) is believed to confer poor prognosis. However, while some of these patients are palliated, others may undergo more aggressive therapies. In this review, we aimed to identify and synthesize findings on the use of peritoneal cytology in predicting peritoneal recurrence and overall survival in curative gastric cancer patients.

Methods

Electronic literature searches were conducted using Medline, EMBASE, and the Cochrane Central Register of Controlled Trials from January 1, 1998 to December 31, 2009. We determined the accuracy, sensitivity, and specificity of peritoneal cytology in predicting peritoneal recurrence based on four techniques—conventional cytology, immunoassay, immunohistochemistry, and reverse transcriptase-polymerase chain reaction. Recurrence rates and overall survival rates for curative patients were determined, based on positivity or negativity for IFCCs.

Results

Twenty-eight articles were included. All four techniques showed wide variations in accuracy, sensitivity, and specificity in predicting peritoneal recurrence. Recurrence rates for patients positive for IFCCs ranged from 11.1 to 100%, while those negative for IFCCs had recurrence rates of 0–51%. Overall survival was significantly reduced for patients with positive IFCCs. Short follow-up periods and possible duplication of results may limit result interpretation.

Conclusion

The presence of IFCCs appears to increase the risk of peritoneal recurrence and is associated with worse overall survival in gastric cancer patients. Further incorporation of peritoneal cytology in clinical decision-making in gastric cancer depends on the development of a consistently accurate and rapid IFCC detection method.

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Boku T, Nakane Y, Minoura T, Takada H, Yamamura M, Hioki K, et al. Prognostic significance of serosal invasion and free intraperitoneal cancer cells in gastric cancer. Br J Surg. 1990;77(4):436–9.PubMedCrossRef

Bonenkamp JJ, Songun I, Hermans J, van de Velde CJ. Prognostic value of positive cytology findings from abdominal washings in patients with gastric cancer. Br J Surg. 1996;83(5):672–4.PubMedCrossRef

Schott A, Vogel I, Krueger U, Kalthoff H, Schreiber HW, Schmiegel W, et al. Isolated tumor cells are frequently detectable in the peritoneal cavity of gastric and colorectal cancer patients and serve as a new prognostic marker. Ann Surg. 1998;227(3):372–9.PubMedCrossRef

Moore GE, Sako K, Kondo T, Badillo J, Burke E. Assessment of the exfoliation of tumor cells into the body cavities. Surg Gynecol Obstet. 1961;112:469–74.PubMed

Creasman WT, Rutledge F. The prognostic value of peritoneal cytology in gynecologic malignant disease. Am J Obstet Gynecol. 1971;110(6):773–81.PubMed

Sobin L, Gospodarowicz M, Wittekind C. TNM classification of malignant tumours. 7th ed. New York: Wiley; 2009.

Badgwell B, Cormier JN, Krishnan S, Yao J, Staerkel GA, Lupo PJ, et al. Does neoadjuvant treatment for gastric cancer patients with positive peritoneal cytology at staging laparoscopy improve survival? Ann Surg Oncol. 2008;15(10):2684–91.PubMedCrossRef

Lorenzen S, Panzram B, Rosenberg R, Nekarda H, Becker K, Schenk U, et al. Prognostic significance of free peritoneal tumor cells in the peritoneal cavity before and after neoadjuvant chemotherapy in patients with gastric carcinoma undergoing potentially curative resection. Ann Surg Oncol. 2010;17(10):2733–9.PubMedCrossRef

Ito S, Kodera Y, Mochizuki Y, Kojima T, Nakanishi H, Yamamura Y. Phase II clinical trial of postoperative S-1 monotherapy for gastric cancer patients with free intraperitoneal cancer cells detected by real-time RT-PCR. World J Surg. 2010;34(9):2083–9.PubMedCrossRef

10.

Yu W, Whang I, Suh I, Averbach A, Chang D, Sugarbaker PH. Prospective randomized trial of early postoperative intraperitoneal chemotherapy as an adjuvant to resectable gastric cancer. Ann Surg. 1998;228(3):347–54.PubMedCrossRef

11.

Kuramoto M, Shimada S, Ikeshima S, Matsuo A, Yagi Y, Matsuda M, et al. Extensive intraoperative peritoneal lavage as a standard prophylactic strategy for peritoneal recurrence in patients with gastric carcinoma. Ann Surg. 2009;250(2):242–6.PubMedCrossRef

12.

Kodera Y, Ito S, Mochizuki Y, Kondo K, Koshikawa K, Suzuki N, et al. A phase II study of radical surgery followed by postoperative chemotherapy with S-1 for gastric carcinoma with free cancer cells in the peritoneal cavity (CCOG0301 study). Eur J Surg Oncol. 2009;35(11):1158–63.PubMedCrossRef

13.

Japanese Gastric Cancer, A. Japanese classification of gastric carcinoma. 3rd English edition. Gastric Cancer. 2011;14(2):101–12.

14.

Hori Y. Diagnostic laparoscopy guidelines: this guideline was prepared by the SAGES Guidelines Committee and reviewed and approved by the Board of Governors of the Society of American Gastrointestinal and Endoscopic Surgeons (SAGES), November 2007. Surg Endosc. 2008;22(5):1353–83.PubMedCrossRef

15.

Okines A, Verheij M, Allum W, Cunningham D, Cervantes A. Gastric cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2010;21(Suppl 5):v50–4.PubMedCrossRef

16.

Ajani JA, Barthel JS, Bekaii-Saab T, Bentrem DJ, D’Amico TA, Das P, et al. Gastric cancer. J Natl Compr Canc Netw. 2010;8(4):378–409.PubMed

17.

Abe S, Yoshimura H, Tabara H, Tachibana M, Monden N, Nakamura T, et al. Curative resection of gastric cancer: limitation of peritoneal lavage cytology in predicting the outcome. J Surg Oncol. 1995;59(4):226–9.PubMedCrossRef

18.

Schofield K, D’Aquila T, Rimm DL. The cell adhesion molecule, E-cadherin, distinguishes mesothelial cells from carcinoma cells in fluids. Cancer. 1997;81(5):293–8.PubMedCrossRef

19.

Benevolo M, Mottolese M, Cosimelli M, Tedesco M, Giannarelli D, Vasselli S, et al. Diagnostic and prognostic value of peritoneal immunocytology in gastric cancer. J Clin Oncol. 1998;16(10):3406–11.PubMed

20.

Vogel I, Kalthoff H. Disseminated tumour cells. Their detection and significance for prognosis of gastrointestinal and pancreatic carcinomas. Virchows Arch. 2001;439(2):109–17.PubMedCrossRef

21.

Bentrem D, Wilton A, Mazumdar M, Brennan M, Coit D. The value of peritoneal cytology as a preoperative predictor in patients with gastric carcinoma undergoing a curative resection. Ann Surg Oncol. 2005;12(5):347–53.PubMedCrossRef

22.

de Manzoni G, Verlato G, Di Leo A, Tomezzoli A, Pedrazzani C, Pasini F, et al. Peritoneal cytology does not increase the prognostic information provided by TNM in gastric cancer. World J Surg. 2006;30(4):579–84.PubMedCrossRef

23.

Euanorasetr C, Lertsithichai P. Prognostic significance of peritoneal washing cytology in Thai patients with gastric adenocarcinoma undergoing curative D2 gastrectomy. Gastric Cancer. 2007;10(1):18–23.PubMedCrossRef

24.

Fujii S, Kitayama J, Kaisaki S, Sasaki S, Seto Y, Tominaga O, et al. Carcinoembryonic antigen mRNA in abdominal cavity as a useful predictor of peritoneal recurrence of gastric cancer with serosal exposure. J Exp Clin Cancer Res. 2002;21(4):547–53.PubMed

25.

Hara M, Nakanishi H, Jun Q, Kanemitsu Y, Ito S, Mochizuki Y, et al. Comparative analysis of intraperitoneal minimal free cancer cells between colorectal and gastric cancer patients using quantitative RT-PCR: possible reason for rare peritoneal recurrence in colorectal cancer. Clin Exp Metastasis. 2007;24(3):179–89.PubMedCrossRef

26.

Irinoda T, Terashima M, Takagane A, Sasaki N, Abe K, Araya M, et al. Carcinoembryonic antigen level in peritoneal washing is a prognostic factor in patients with gastric cancer. Oncol Rep. 1998;5((3):661–6.PubMed

27.

Ishii T, Fujiwara Y, Ohnaka S, Hayashi T, Taniguchi H, Takiguchi S, et al. Rapid genetic diagnosis with the transcription-reverse transcription concerted reaction system for cancer micrometastasis. Ann Surg Oncol. 2004;11(8):778–85.PubMedCrossRef

28.

Ito S, Nakanishi H, Kodera Y, Mochizuki Y, Tatematsu M, Yamamura Y. Prospective validation of quantitative CEA mRNA detection in peritoneal washes in gastric carcinoma patients. Br J Cancer. 2005;93(9):986–92.PubMedCrossRef

29.

Katsuragi K, Yashiro M, Sawada T, Osaka H, Ohira M, Hirakawa K. Prognostic impact of PCR-based identification of isolated tumour cells in the peritoneal lavage fluid of gastric cancer patients who underwent a curative R0 resection. Br J Cancer. 2007;97((4):550–6.PubMedCrossRef

30.

Kodera Y, Nakanishi H, Yamamura Y, Shimizu Y, Torii A, Hirai T, et al. Prognostic value and clinical implications of disseminated cancer cells in the peritoneal cavity detected by reverse transcriptase-polymerase chain reaction and cytology. Int J Cancer. 1998;79(4):429–33.PubMedCrossRef

31.

Kodera Y, Yamamura Y, Shimizu Y, Torii A, Hirai T, Yasui K, et al. Peritoneal washing cytology: prognostic value of positive findings in patients with gastric carcinoma undergoing a potentially curative resection. J Surg Oncol. 1999;72(2):60–4 (discussion 4–5).

32.

Kodera Y, Yamamura Y, Ito S, Kanemitsu Y, Shimizu Y, Hirai T, et al. Is Borrmann type IV gastric carcinoma a surgical disease? An old problem revisited with reference to the result of peritoneal washing cytology. J Surg Oncol. 2001;78(3):175–81 (discussion 81–2).

33.

Li JK, Zheng M, Miao CW, Zhang JH, Ding GH, Wu WS. Peritoneal lavage cytology and carcinoembryonic antigen determination in predicting peritoneal metastasis and prognosis of gastric cancer. World J Gastroenterol. 2005;11(46):7374–7.PubMed

34.

Miyashiro I, Takachi K, Doki Y, Ishikawa O, Ohigashi H, Murata K, et al. When is curative gastrectomy justified for gastric cancer with positive peritoneal lavage cytology but negative macroscopic peritoneal implant? World J Surg. 2005;29(9):1131–4.PubMedCrossRef

35.

Mori K, Suzuki T, Uozaki H, Nakanishi H, Ueda T, Matsuno Y, et al. Detection of minimal gastric cancer cells in peritoneal washings by focused microarray analysis with multiple markers: clinical implications. Ann Surg Oncol. 2007;14(5):1694–702.PubMedCrossRef

36.

Nakanishi H, Kodera Y, Yamamura Y, Kuzuya K, Nakanishi T, Ezaki T, et al. Molecular diagnostic detection of free cancer cells in the peritoneal cavity of patients with gastrointestinal and gynecologic malignancies. Cancer Chemother Pharmacol. 1999;43(Suppl):S32–6.PubMedCrossRef

37.

Nekarda H, Gess C, Stark M, Mueller JD, Fink U, Schenck U, et al. Immunocytochemically detected free peritoneal tumour cells (FPTC) are a strong prognostic factor in gastric carcinoma. Br J Cancer. 1999;79(3–4):611–9.PubMedCrossRef

38.

Oyama K, Terashima M, Takagane A, Maesawa C. Prognostic significance of peritoneal minimal residual disease in gastric cancer detected by reverse transcription-polymerase chain reaction. Br J Surg. 2004;91(4):435–43.PubMedCrossRef

39.

Ribeiro U Jr, Safatle-Ribeiro AV, Zilberstein B, Mucerino D, Yagi OK, Bresciani CC, et al. Does the intraoperative peritoneal lavage cytology add prognostic information in patients with potentially curative gastric resection? J Gastrointest Surg. 2006;10(2):170–6 (discussion 6–7).

40.

Rosenberg R, Nekarda H, Bauer P, Schenck U, Hoefler H, Siewert JR. Free peritoneal tumour cells are an independent prognostic factor in curatively resected stage IB gastric carcinoma. Br J Surg. 2006;93(3):325–31.PubMedCrossRef

41.

Sugita Y, Fujiwara Y, Taniguchi H, Mori T, Ishii T, Niwa H, et al. Quantitative molecular diagnosis of peritoneal lavage fluid for prediction of peritoneal recurrence in gastric cancer. Int J Oncol. 2003;23(5):1419–23.PubMed

42.

Tokuda K, Natsugoe S, Nakajo A, Miyazono F, Ishigami S, Hokita S, et al. Clinical significance of CEA-mRNA expression in peritoneal lavage fluid from patients with gastric cancer. Int J Mol Med. 2003;11(1):79–84.PubMed

43.

Tsutsumi S, Asao T, Shimura T, Mochiki E, Kato R, Kuwano H. A novel rapid colorimetric assay of carcinoembryonic antigen levels in the abdominal cavity to detect peritoneal micrometastasis during gastric cancer surgery. Cancer Lett. 2000;149(1–2):1–5.PubMedCrossRef

44.

Vogel P, Ruschoff J, Kummel S, Zirngibl H, Hofstadter F, Hohenberger W, et al. Immunocytology improves prognostic impact of peritoneal tumour cell detection compared to conventional cytology in gastric cancer. Eur J Surg Oncol. 1999;25(5):515–9.PubMedCrossRef

45.

Wang JY, Lin SR, Lu CY, Chen CC, Wu DC, Chai CY, et al. Gastric cancer cell detection in peritoneal lavage: RT-PCR for carcinoembryonic antigen transcripts versus the combined cytology with peritoneal carcinoembryonic antigen levels. Cancer Lett. 2005;223((1):129–35.PubMedCrossRef

46.

Yonemura Y, Endou Y, Fujimura T, Fushida S, Bandou E, Kinoshita K, et al. Diagnostic value of preoperative RT-PCR-based screening method to detect carcinoembryonic antigen-expressing free cancer cells in the peritoneal cavity from patients with gastric cancer. ANZ J Surg. 2001;71(9):521–8.PubMedCrossRef

47.

Yonemura Y, Fujimura T, Ninomiya I, Kim BS, Bandou E, Sawa T, et al. Prediction of peritoneal micrometastasis by peritoneal lavaged cytology and reverse transcriptase-polymerase chain reaction for matrix metalloproteinase-7 mRNA. Clin Cancer Res. 2001;7(6):1647–53.PubMed

48.

Yoshikawa T, Tsuburaya A, Kobayashi O, Sairenji M, Motohashi H, Noguchi Y. Peritoneal cytology in patients with gastric cancer exposed to the serosa—a proposed new classification based on the local and distant cytology. Hepatogastroenterology. 2003;50(52):1183–6.PubMed

49.

Elaraj DM, Ettinghausen SE. Cytological analysis of peritoneal washings: now part of the standard preoperative staging evaluation for patients with resectable gastric cancer? Ann Surg Oncol. 2005;12(5):339–41.PubMedCrossRef

50.

Nakanishi H, Kodera Y, Yamamura Y, Ito S, Kato T, Ezaki T, et al. Rapid quantitative detection of carcinoembryonic antigen-expressing free tumor cells in the peritoneal cavity of gastric-cancer patients with real-time RT-PCR on the lightcycler. Int J Cancer. 2000;89(5):411–7.PubMedCrossRef

51.

Ohashi N, Nakanishi H, Kodera Y, Ito S, Mochizuki Y, Koike M, et al. Intraoperative quantitative detection of CEA mRNA in the peritoneal lavage of gastric cancer patients with transcription reverse-transcription concerted (TRC) method. A comparative study with real-time quantitative RT-PCR. Anticancer Res. 2007;27(4C):2769–77.PubMed

52.

Kodera Y, Nakanishi H, Ito S, Mochizuki Y, Ohashi N, Yamamura Y, et al. Prognostic significance of intraperitoneal cancer cells in gastric carcinoma: analysis of real time reverse transcriptase-polymerase chain reaction after 5 years of followup. J Am Coll Surg. 2006;202(2):231–6.PubMedCrossRef

53.

Kodera Y, Nakanishi H, Ito S, Yamamura Y, Kanemitsu Y, Shimizu Y, et al. Quantitative detection of disseminated cancer cells in the greater omentum of gastric carcinoma patients with real-time RT-PCR: a comparison with peritoneal lavage cytology. Gastric Cancer. 2002;5(2):69–76.PubMedCrossRef

54.

Yonemura Y, Ninomiya I, Kaji M, Sugiyama K, Fujimura K, Sawa T, et al. Prophylaxis with intraoperative chemohyperthermia against peritoneal recurrence of serosal invasion-positive gastric cancer. World J Surg. 1995;19(3):450–4 (discussion 5).

55.

Mezhir JJ, Shah MA, Jacks LM, Brennan MF, Coit DG, Strong VE. Positive peritoneal cytology in patients with gastric cancer: natural history and outcome of 291 patients. Ann Surg Oncol. 2010;17(12):3173–80.PubMedCrossRef

Titel: A systematic review of the accuracy and utility of peritoneal cytology in patients with gastric cancer
verfasst von: Pierre-Anthony Leake
Roberta Cardoso
Rajini Seevaratnam
Laercio Lourenco
Lucy Helyer
Alyson Mahar
Corwyn Rowsell
Natalie G. Coburn
Publikationsdatum: 01.09.2012
Verlag: Springer Japan
Erschienen in: Gastric Cancer / Ausgabe Sonderheft 1/2012
Print ISSN: 1436-3291
Elektronische ISSN: 1436-3305
DOI: https://doi.org/10.1007/s10120-011-0071-z

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A systematic review of the accuracy and utility of peritoneal cytology in patients with gastric cancer