Implications of peritoneal cytology for XXXX management.

@entity1 @entity788 @entity3
OBJECTIVE: To assess the implications of positive cytology for malignant cells (positive results) from peritoneal washings in the management of @entity1 with @entity788 . DESIGN: Retrospective cohort study. SETTING: Referral practice in a university hospital. @entity1 : A total of 32 consecutive @entity788 @entity1 with positive results from peritoneal washings during a 4-year period, 17 with visible biopsy-proven intraabdominal @entity3 at the time of laparoscopy or laparotomy and 15 without visible @entity3 . A treatment-matched control group of 30 @entity1 was randomly selected from a group of 105 @entity1 with negative cytology for malignant cells (negative results) from peritoneal-fluid cytology. INTERVENTIONS: Eight of 17 @entity1 with visible @entity3 underwent treatment with chemotherapy, radiation, or both; 13 of the 15 @entity1 with no visible @entity3 underwent further treatment, including pancreatic resection in 2 @entity1 and external beam radiation in 13 @entity1 (3 with intraoperative radiation therapy). MAIN OUTCOME MEASURES: Time to @entity3 and mortality. RESULTS: Median survival among @entity1 with and without visible @entity3 was 7.8 months and 8.6 months, respectively (P=.95), despite the fact that @entity1 without visible @entity3 received more treatment. @entity1 without visible @entity3 at presentation were found to have metastatic disease as documented by computed tomographic scan or subsequent laparotomy at a median time of 2.9 months. The survival of treatment-matched @entity1 with negative cytology was significantly longer (median, 13.5 months; P=.04). CONCLUSIONS: @entity788 @entity1 with peritoneal micrometastases have a dismal outcome even without macroscopic @entity3 . Since these @entity1 do not benefit from local therapy, the finding of a positive result from peritoneal-fluid cytologic testing contraindicates further irradiation or surgery, except for specific complications.
