Peritoneal Cytology

PFCC are exfoliated free cancer cells from the primary lesion. Patients with radiologically resectable gastric cancer but positive IPFCC have been shown to be significantly associated with early disease recurrence and poor survival, despite R0 resection. Therefore, IPFCC is a marker of peritoneal micrometastatic development even in patients with no visible evidence of peritoneal disease on laparoscopy. In this context, peritoneal washing cytology provides invaluable staging information which predicts the possibility of peritoneal recurrence or treatment failure and allows targeted therapeutic approach to gastric cancer. The Japanese Classification of Gastric Carcinoma (JCGC) recommended peritoneal wash cytology as part of staging for gastric cancer since 1990s and patients with positive IPFCC have been regarded as Stage IV disease. While the Society of American Gastroenterologists and Endoscopic Surgeons (SAGES) values peritoneal washings during staging laparoscopy, the European Society for Medical Oncology (ESMO) perceives peritoneal washings as non-obligatory . Only recently, the American Joint Committee on Cancer (AJCC) staging system in 2010 had included peritoneal cytology into the TNM 7th Edition, with a positive peritoneal cytology staged as M1 disease. Despite these internationally renowned classification systems, the practice of peritoneal washings in the Western countries is not uniform or routine due to several unresolved concerns

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Last date updated on April, 2024