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

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

  • نوع فایل : کتاب
  • زبان : انگلیسی
  • مؤلف : Pierre-Anthony Leake Roberta Cardoso Rajini Seevaratnam Laercio Lourenco Lucy Helyer Alyson Mahar Corwyn Rowsell Natalie G. Coburn
  • چاپ و سال / کشور: 2011

Description

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 decisionmaking in gastric cancer depends on the development of a consistently accurate and rapid IFCC detection method
Gastric Cancer DOI 10.1007/s10120-011-0071-z Received: 28 February 2011 / Accepted: 29 May 2011
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