Localized pancreatic cancer with positive peritoneal cytology as a sole manifestation of metastatic disease: a single-institution experience

Stephen Y. Oh, Alicia Edwards, Margaret T. Mandelson, Hejin Hahn, Adnan Alseidi, Thomas Biehl, Richard A. Kozarek, Flavio G. Rocha, Scott Helton, Vincent J. Picozzi

Research output: Contribution to journalArticlepeer-review

3 Scopus citations

Abstract

Background Pancreatic cancer patients with positive peritoneal cytology (PPC) as a sole metastatic site are poorly characterized. Whether they behave similarly to other stage IV patients is unknown. Methods Patients with stage IV disease at our institution between 2003 and 2013 were identified. Inclusion criteria for PPC cohort were PPC at laparoscopy and no laparoscopic and/or radiographic evidence of metastasis. Patients with gross metastasis had laparoscopic and/or radiographic evidence of metastasis. Results Among 308 patients, 43 patients had PPC and 265 had gross metastasis. PPC cohort: 3 (7%) resectable, 8 (19%) borderline resectable, and 32 (74%) unresectable tumor. Disease progression occurred in 37 (86%). Sixteen of 43 (37%) also received local therapy (1 surgery and 15 chemoradiation). PPC vs gross metastasis cohort differed as follows: baseline Ca 19-9 (440 vs 1,904 IU/mL, P < .0001); Eastern Cooperative Oncology Group (ECOG) score ≤1 (98 vs 88%, P =.04); median overall survival (13.9 vs 9.4 months, P = .0001). Conclusions Patients with PPC failed to display long-term disease-free survival, although overall survival was superior compared with those with gross metastasis. Patients with PPC may need to be considered a specific subgroup for staging and survival analysis.

Original languageEnglish (US)
Pages (from-to)94-99
Number of pages6
JournalAmerican journal of surgery
Volume213
Issue number1
DOIs
StatePublished - Jan 1 2017
Externally publishedYes

Keywords

  • Cancer staging
  • Chemoradiation
  • Disease progression
  • Laparoscopy
  • Peritoneal washing
  • Survival

ASJC Scopus subject areas

  • Surgery

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