Department of Surgery, Graduate School of Biomedical and Health Science, Hiroshima University, 1 2 3 Kasumi, Minami ku, Hiroshima, 734 8551, Japan.
Department of Gastroenterology and Metabolism, Graduate School of Biomedical and Health Science, Hiroshima University, Hiroshima, Japan.
Surg Today. 2021 Jul;51(7):1227-1231. doi: 10.1007/s00595-020-02208-y. Epub 2021 Jan 20.
The clinical importance of peritoneal washing cytology (PWC) for cholangiocarcinoma patients remains unclear. The clinical data of 137 extrahepatic cholangiocarcinoma patients who received PWC and curative surgery were retrospectively analyzed. Among the 137 patients analyzed, five (3.6%) had positive PWC, and 132 (96.4%) had negative PWC. The median survival time in patients with negative PWC was 6.45 years, and the overall 1-, 2-, and 5-year survival rates were 86.5%, 75.3%, and 51.6%, respectively. The median survival time in patients with positive PWC was 2.56 years, and the overall 1-, 2-, and 5-year survival rates were 60.0%, 60.0%, and 40.0%, respectively. A multivariate analysis revealed that positive lymph node metastasis (P < 0.001), positive perineural invasion (P = 0.014) and no use of adjuvant chemotherapy (P < 0.001), but not positive PWC were independently associated with a worse overall survival. In conclusion, surgery and subsequent chemotherapy might be a therapeutic option for cholangiocarcinoma patients with positive PWC.
腹膜冲洗细胞学（PWC）对胆管癌患者的临床重要性仍不清楚。回顾性分析了 137 例接受 PWC 和根治性手术的肝外胆管癌患者的临床资料。在分析的 137 例患者中，5 例（3.6%）PWC 阳性，132 例（96.4%）PWC 阴性。PWC 阴性患者的中位生存时间为 6.45 年，总体 1、2、5 年生存率分别为 86.5%、75.3%和 51.6%。PWC 阳性患者的中位生存时间为 2.56 年，总体 1、2、5 年生存率分别为 60.0%、60.0%和 40.0%。多因素分析显示，阳性淋巴结转移（P<0.001）、阳性神经周围侵犯（P=0.014）和未使用辅助化疗（P<0.001）与总体生存不良独立相关，但 PWC 阳性与总体生存不良无关。总之，手术和随后的化疗可能是 PWC 阳性胆管癌患者的一种治疗选择。
