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Conventional peritoneal cytology lacks the prognostic significance of detecting local or peritoneal recurrence in colorectal cancer: An Egyptian experience

BACKGROUND AND AIM: Colorectal cancer (CRC) accounts for over 8% of all deaths each year, with 1.2 million new cases diagnosed annually worldwide. It represents the seventh most common cancer in Egypt. Early detection of peritoneal metastasis is a major challenge in such cases. It helps with the dec...

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Autores principales: Shalaby, Mohamed, El Baradie, Tarek S, Salama, Mohamed, Shaaban, Hebat A M, Allam, Rasha M, Hafiz, Ehab O.A., Abdelhamed, Mohamed Aly, Attia, Amr
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wiley Publishing Asia Pty Ltd 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7857300/
https://www.ncbi.nlm.nih.gov/pubmed/33553666
http://dx.doi.org/10.1002/jgh3.12482
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author Shalaby, Mohamed
El Baradie, Tarek S
Salama, Mohamed
Shaaban, Hebat A M
Allam, Rasha M
Hafiz, Ehab O.A.
Abdelhamed, Mohamed Aly
Attia, Amr
author_facet Shalaby, Mohamed
El Baradie, Tarek S
Salama, Mohamed
Shaaban, Hebat A M
Allam, Rasha M
Hafiz, Ehab O.A.
Abdelhamed, Mohamed Aly
Attia, Amr
author_sort Shalaby, Mohamed
collection PubMed
description BACKGROUND AND AIM: Colorectal cancer (CRC) accounts for over 8% of all deaths each year, with 1.2 million new cases diagnosed annually worldwide. It represents the seventh most common cancer in Egypt. Early detection of peritoneal metastasis is a major challenge in such cases. It helps with the decision of the immediate application of intraperitoneal chemotherapy after resection. Meta‐analysis studies reported contrast evidence for a possible prognostic role of intraperitoneal free cancer cells (IPCCs) in peritoneal recurrence and survival after curative resection. In this work, we aim to evaluate the prevalence and impact of detecting free malignant cells in peritoneal fluid on survival and local recurrence and to estimate the incidence of peritoneal carcinomatosis (PC) during follow up. METHODS: Design: This was a prospective cohort study. Settings: From June 2016 to December 2018, samples were collected from 104 patients who underwent abdominal surgery for colorectal cancer in the Egyptian National Cancer Institute. A total of 96 Egyptian CRC patients who underwent curative resection were enrolled. Intraoperative peritoneal lavage was performed to detect IPCC by conventional cytology. Patients with no residual tumor after surgery and no evidence of PC were followed up for a median 14 months. The cumulative 12‐month overall survival rate for patients with IPCC was 100% versus 86% for patients with negative cytology. RESULTS: Our results demonstrated that the prevalence of IPCC in the peritoneal lavage was 11.5%. Peritoneal and local recurrence occurred at a higher rate in patients with cytology positive lavage (9.1% vs 6.3% and 9.1% vs 3.8%, respectively), although this was statistically insignificant. Distant metastasis occurred significantly in patients with positive cytology (45.5% vs 8.9%) with P‐value <0.001.The conventional cytology technique has a high specificity but less sensitivity. CONCLUSIONS: The presence of IPCC using conventional cytology was not an independent prognostic factor for the development of PC or survival.
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spelling pubmed-78573002021-02-05 Conventional peritoneal cytology lacks the prognostic significance of detecting local or peritoneal recurrence in colorectal cancer: An Egyptian experience Shalaby, Mohamed El Baradie, Tarek S Salama, Mohamed Shaaban, Hebat A M Allam, Rasha M Hafiz, Ehab O.A. Abdelhamed, Mohamed Aly Attia, Amr JGH Open Original Articles BACKGROUND AND AIM: Colorectal cancer (CRC) accounts for over 8% of all deaths each year, with 1.2 million new cases diagnosed annually worldwide. It represents the seventh most common cancer in Egypt. Early detection of peritoneal metastasis is a major challenge in such cases. It helps with the decision of the immediate application of intraperitoneal chemotherapy after resection. Meta‐analysis studies reported contrast evidence for a possible prognostic role of intraperitoneal free cancer cells (IPCCs) in peritoneal recurrence and survival after curative resection. In this work, we aim to evaluate the prevalence and impact of detecting free malignant cells in peritoneal fluid on survival and local recurrence and to estimate the incidence of peritoneal carcinomatosis (PC) during follow up. METHODS: Design: This was a prospective cohort study. Settings: From June 2016 to December 2018, samples were collected from 104 patients who underwent abdominal surgery for colorectal cancer in the Egyptian National Cancer Institute. A total of 96 Egyptian CRC patients who underwent curative resection were enrolled. Intraoperative peritoneal lavage was performed to detect IPCC by conventional cytology. Patients with no residual tumor after surgery and no evidence of PC were followed up for a median 14 months. The cumulative 12‐month overall survival rate for patients with IPCC was 100% versus 86% for patients with negative cytology. RESULTS: Our results demonstrated that the prevalence of IPCC in the peritoneal lavage was 11.5%. Peritoneal and local recurrence occurred at a higher rate in patients with cytology positive lavage (9.1% vs 6.3% and 9.1% vs 3.8%, respectively), although this was statistically insignificant. Distant metastasis occurred significantly in patients with positive cytology (45.5% vs 8.9%) with P‐value <0.001.The conventional cytology technique has a high specificity but less sensitivity. CONCLUSIONS: The presence of IPCC using conventional cytology was not an independent prognostic factor for the development of PC or survival. Wiley Publishing Asia Pty Ltd 2020-12-29 /pmc/articles/PMC7857300/ /pubmed/33553666 http://dx.doi.org/10.1002/jgh3.12482 Text en © 2020 The Authors. JGH Open: An open access journal of gastroenterology and hepatology published by Journal of Gastroenterology and Hepatology Foundation and John Wiley & Sons Australia, Ltd. This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.
spellingShingle Original Articles
Shalaby, Mohamed
El Baradie, Tarek S
Salama, Mohamed
Shaaban, Hebat A M
Allam, Rasha M
Hafiz, Ehab O.A.
Abdelhamed, Mohamed Aly
Attia, Amr
Conventional peritoneal cytology lacks the prognostic significance of detecting local or peritoneal recurrence in colorectal cancer: An Egyptian experience
title Conventional peritoneal cytology lacks the prognostic significance of detecting local or peritoneal recurrence in colorectal cancer: An Egyptian experience
title_full Conventional peritoneal cytology lacks the prognostic significance of detecting local or peritoneal recurrence in colorectal cancer: An Egyptian experience
title_fullStr Conventional peritoneal cytology lacks the prognostic significance of detecting local or peritoneal recurrence in colorectal cancer: An Egyptian experience
title_full_unstemmed Conventional peritoneal cytology lacks the prognostic significance of detecting local or peritoneal recurrence in colorectal cancer: An Egyptian experience
title_short Conventional peritoneal cytology lacks the prognostic significance of detecting local or peritoneal recurrence in colorectal cancer: An Egyptian experience
title_sort conventional peritoneal cytology lacks the prognostic significance of detecting local or peritoneal recurrence in colorectal cancer: an egyptian experience
topic Original Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7857300/
https://www.ncbi.nlm.nih.gov/pubmed/33553666
http://dx.doi.org/10.1002/jgh3.12482
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