Journal of Cytology

ORIGINAL ARTICLE
Year
: 2020  |  Volume : 37  |  Issue : 1  |  Page : 40--45

The incidence of free peritoneal tumor cells before and after neoadjuvant chemotherapy in gastroesophageal junction cancer


Rune B Strandby1, Lars B Svendsen1, Rikard Ambrus1, Andreas A Rostved1, Jane P Hasselby2, Michael P Achiam1 
1 Department of Surgical Gastroenterology, Copenhagen University Hospital Rigshospitalet, Blegdamsvej 9, 2100 Copenhagen Ø, Denmark
2 Department of Pathology, Copenhagen University Hospital Rigshospitalet, Blegdamsvej 9, 2100 Copenhagen Ø, Denmark

Correspondence Address:
Dr. Rune B Strandby
Department of Surgical Gastroenterology, Inge Lehmanns Vej 7, 2100 Copenhagen Ø
Denmark

Context: The utility of peritoneal washing cytology in patients with gastroesophageal junction cancer has not been thoroughly evaluated. Aims: The study aimed to determine the incidence of free peritoneal tumor cells by peritoneal washing cytology before and after neoadjuvant chemotherapy using conventional cytopathological methods and immunohistochemical staining for the analysis of peritoneal washings. Settings and Design: A prospective study conducted at a single tertiary referral hospital. Materials and Methods: Patients with gastroesophageal junction cancer and without suspicion of intra- or extraabdominal metastases before the staging laparoscopy were prospectively and consecutively enrolled. Peritoneal washing cytology was performed at staging laparoscopy (primary cytology) and after neoadjuvant chemotherapy during robot-assisted or open resection (secondary cytology). Peritoneal fluid samples were analyzed by conventional cytology and an immunohistochemical panel. Results: Overall, 81 patients met the primary inclusion criteria. During primary cytology, positive cytology without overt metastases (C1M0) was detected in three patients (3.8%) while five patients (6.3%) had overt intra-abdominal metastases but negative cytology (C0M1). None of the patients with C1M0 underwent surgery due to extra-abdominal (n = 1) or intra-abdominal metastases (n = 2), and the overall survival was 4, 7, and 14 months. During secondary cytology, no patients with free peritoneal tumor cells were identified, but seven patients were classified as C0M1 (10.9%). Conclusions: The incidence of C1M0 was 3.8% and 0% before and after neoadjuvant chemotherapy, respectively in patients with gastroesophageal junction cancer. Free peritoneal tumor cells were not identified in several patients with intra-abdominal metastases suggesting that peritoneal washing cytology with conventional cytology and immunohistochemical staining lack sensitivity.


How to cite this article:
Strandby RB, Svendsen LB, Ambrus R, Rostved AA, Hasselby JP, Achiam MP. The incidence of free peritoneal tumor cells before and after neoadjuvant chemotherapy in gastroesophageal junction cancer.J Cytol 2020;37:40-45


How to cite this URL:
Strandby RB, Svendsen LB, Ambrus R, Rostved AA, Hasselby JP, Achiam MP. The incidence of free peritoneal tumor cells before and after neoadjuvant chemotherapy in gastroesophageal junction cancer. J Cytol [serial online] 2020 [cited 2020 Apr 9 ];37:40-45
Available from: http://www.jcytol.org/article.asp?issn=0970-9371;year=2020;volume=37;issue=1;spage=40;epage=45;aulast=Strandby;type=0