INCIDENCE OF POSITIVE PERITONEAL CYTOLOGY IN COLORECTAL CANCER PATIENTS AT A REFERRAL HOSPITAL IN SALVADOR, BRAZIL

Introduction: Peritoneal metastasis (PM) defines TNM stage IV in patients with colorectal cancer (CRC). The treatment of this condition was restricted to palliative chemotherapy. The survival of patients with undergoing cytoreductive surgery with or without hyperthermic intraperitoneal chemotherapychanged the treatment paradigm. Although scientific data is still needed to define consensus protocols. Published data defines that positive peritoneal cytology is a poor prognostic factor in gynecological, gastric and pancreatic cancer. But data on the prognostic evidence of positive peritoneal cytology in CRC are still controversial, altough 10% of CRC patients have PM. Objectives: This study aims to analyze the incidence of positive peritoneal cytology in patients with CRC undergoing surgical treatment in a cancer reference hospital. Methodology: This is a prospective study conducted from October 2018 to April 2019, based on the collection of peritoneal lavages before and after surgical resection, using Papanicolaus cytological technique, as well as the histopathological study of the resected specimens of CRC patients undergoing surgical treatment. Results: 58 patients were included in the study. The average age was 60.1 years. 33 (56.9%) of the tumors were in the colon and 25 (43.1%) in the rectum. 16 (27.6%) patients had stage IV, 7 with livermetastases and 2 PM. Only one case (1.7%), with stage IV disease, showed positive peritoneal cytology; the patient had liver metastases, but without peritoneal macroscopic implants. Of the 2 patients with PM (3.4%), none of the lavages were positive. Conclusion: The incidence of positive peritoneal lavage reported in most studies ranges from 1.6% to 21%. This study had a low incidence of positive peritoneal lavage (1.7%). The main factor that seems to be directly related to this low incidence of positive peritoneal lavage is the used cytological study methodology, with Papanicolaus staining. For a better evaluation of peritoneal cytology, the staining techniques and histopathological evaluation should be expanded. Patients will be followed up to assess whether the cytology findings of peritoneal lavage confer any oncologic prognostic factor.

 

MissingLinkText

No conflict of interest has been declared by the author(s).

Publication History

Article published online:
23 October 2019