Satoshi Matsukuma1,2, Hiroaki Nagano1,2, Shogo Kobayashi2,3, Hiroshi Wada2,4, Satoru Seo2,5, Daisuke Tsugawa2,6, Hiroyuki Okuyama2,7, Kenjiro Iida2,8, Yoshiaki Ohmura2,9, Yutaka Takeda2,9, Atsushi Miyamoto2,10, Shinsuke Nakashima2,11, Terumasa Yamada2,11, Tetsuo Ajiki2,6, Akihito Tsuji2,7, Kenichi Yoshimura2,12, Hidetoshi Eguchi2,3, Etsuro Hatano2,8, Tatsuya Ioka2,13. 1. Department of Gastroenterological, Breast and Endocrine Surgery, Yamaguchi University Graduate School of Medicine, Yamaguchi, Japan. 2. Kansai Hepato-Biliary Oncology Group, Osaka, Japan. 3. Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Osaka, Japan. 4. Department of Surgery, Osaka International Cancer Institute, Osaka, Japan. 5. Department of Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan. 6. Division of Hepato-Biliary-Pancreatic Surgery, Department of Surgery, Graduate School of Medicine, Kobe University, Kobe, Japan. 7. Department of Clinical Oncology, Kagawa University Hospital, Kagawa, Japan. 8. Department of Gastroenterological Surgery, Hyogo College of Medicine, Nishinomiya, Japan. 9. Department of Surgery, Kansai Rosai Hospital, Amagasaki, Japan. 10. Department of Surgery, Osaka National Hospital, Osaka, Japan. 11. Department of Surgery, Higashiosaka City Medical Center, Osaka, Japan. 12. Medical Center for Clinical and Translational Research, Hiroshima University Hospital, Hiroshima, Japan. 13. Department of Oncology Center, Yamaguchi University Hospital, Yamaguchi, Japan.
Abstract
BACKGROUND: Only few studies in literature have analyzed the clinical effects of peritoneal lavage status in biliary tract cancers. AIM: We aimed to assess the effect of cytology-positive peritoneal lavage on survival for patients with biliary tract cancer who underwent curative resection. METHODS: The KHBO1701 study was a multi-institutional retrospective study that assessed the clinical effects of peritoneal lavage cytology in biliary tract cancers. Using clinicopathological data from 11 Japanese institutions, we compared long-term outcomes between patients with cytology-positive and cytology-negative peritoneal lavage. RESULTS: Of 169 patients who underwent curative resection, 164 were cytology-negative, and five were cytology-positive. The incidence of portal invasion and preoperative carbohydrate antigen 19-9 levels were higher in the cytology-positive group than in the cytology-negative group. The incidence of peritoneal metastatic recurrence was also higher, and overall survival tended to be worse in the cytology-positive group. In contrast, recurrence-free survival was similar between the cytology-negative and cytology-positive groups. CONCLUSIONS: The positive status of peritoneal lavage cytology could moderately affect the survival of patients with biliary tract cancers. Given that surgical resection is the only curative treatment option, it may be acceptable to resect biliary tract cancers without other non-curative factors, regardless of peritoneal lavage cytology status.
BACKGROUND: Only few studies in literature have analyzed the clinical effects of peritoneal lavage status in biliary tract cancers. AIM: We aimed to assess the effect of cytology-positive peritoneal lavage on survival for patients with biliary tract cancer who underwent curative resection. METHODS: The KHBO1701 study was a multi-institutional retrospective study that assessed the clinical effects of peritoneal lavage cytology in biliary tract cancers. Using clinicopathological data from 11 Japanese institutions, we compared long-term outcomes between patients with cytology-positive and cytology-negative peritoneal lavage. RESULTS: Of 169 patients who underwent curative resection, 164 were cytology-negative, and five were cytology-positive. The incidence of portal invasion and preoperative carbohydrate antigen 19-9 levels were higher in the cytology-positive group than in the cytology-negative group. The incidence of peritoneal metastatic recurrence was also higher, and overall survival tended to be worse in the cytology-positive group. In contrast, recurrence-free survival was similar between the cytology-negative and cytology-positive groups. CONCLUSIONS: The positive status of peritoneal lavage cytology could moderately affect the survival of patients with biliary tract cancers. Given that surgical resection is the only curative treatment option, it may be acceptable to resect biliary tract cancers without other non-curative factors, regardless of peritoneal lavage cytology status.