Valor prognóstico da citologia positiva no lavado peritoneal de pacientes com câncer gástrico ressecável Prognostic role of positive peritoneal cytology in patients with resectable gastric cancer

Abstract

OBJETIVO: Avaliar o valor prognóstico do lavado peritoneal positivo em pacientes com câncer gástrico sem sinais de disseminação peritoneal ou hematogênica. MÉTODOS: Foram avaliados os pacientes com adenocarcinoma gástrico tratados com operação de intenção curativa. O lavado peritoneal foi classificado como positivo ou negativo para células neoplásicas. Foram obtidos dados demográficos, performance status, histológicos e tipo de operação realizada. Os resultados foram estatisticamente comparados e considerados significantes para valores de pOBJECTIVE: To evaluate the prognostic value of positive peritoneal lavage in patients with gastric cancer without signs of peritoneal or hematogenous spread. METHODS: We evaluated patients with gastric adenocarcinoma treated with curative intent operation. The peritoneal lavage was classified as positive or negative for neoplastic cells. We obtained demographics, performance status, histology and type of surgery. The results were statistically compared and were considered significant for values of p <0.05. RESULTS: We included 72 patients with gastric adenocarcinoma. During a mean follow up of 26 months (one to 39 months) we observed 20 local or distant recurrences and 21 deaths. Only the presence of lymph node metastases and the need for resection of adjacent organs were associated with a significant reduction in relapse-free survival. There was a significant reduction in overall survival in patients with angio-lymphatic invasion, lymph node metastasis, requiring resection of multiple organs, need for total gastrectomy and greater invasion of the gastric wall. The presence of tumor cells in the peritoneal cavity was associated with worse overall survival, but without statistical significance. CONCLUSION: There was no statistically significant associations between positive peritoneal citology and recurrence-free survival or overall survival among patients with resectable gastric cancer