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

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 2003-2013 were identified....

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Bibliographic Details
Published in:The American journal of surgery 2017-01, Vol.213 (1), p.94-99
Main Authors: Oh, Stephen Y., MBBS, BSc, Edwards, Alicia, MBA, Mandelson, Margaret T., PhD, Hahn, Hejin, MD, Alseidi, Adnan, MD, Biehl, Thomas, MD, Kozarek, Richard A., MD, Rocha, Flavio G., MD, Helton, Scott, MD, Picozzi, Vincent J., MD
Format: Article
Language:English
Subjects:
Adenocarcinoma - mortality
Adenocarcinoma - secondary
Adenocarcinoma - therapy
Adult
Aged
Aged, 80 and over
Cancer staging
Cancer therapies
Cellular biology
Chemoradiation
Chemoradiotherapy
Chemotherapy
Disease progression
Disease-Free Survival
Female
Humans
Laparoscopy
Male
Medical imaging
Metastasis
Middle Aged
Neoplasm Staging
Pancreatic cancer
Pancreatic Neoplasms - mortality
Pancreatic Neoplasms - pathology
Pancreatic Neoplasms - therapy
Patients
Peritoneal washing
Peritoneum - pathology
Retrospective Studies
Surgeons
Surgery
Survival
Survival analysis
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Summary: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 2003-2013 were identified. Inclusion criteria for PPC cohort were PPC at laparoscopy and no laparoscopic/radiographic evidence of metastasis. Patients with gross metastasis had laparoscopic/radiographic evidence of metastasis. Results Among 308 patients, 43 patients had PPC and 265 gross metastasis. PPC cohort: 3 (7%) resectable, 8 (19%) borderline resectable, and 32 (74%) unresectable tumor. Disease progression occurred in 37 (86%). 16/43 (37%) also received local therapy (1 surgery, 15 chemoradiation). PPC vs. gross metastasis cohort differed as follows: baseline Ca 19-9 (440 vs. 1904 IU/mL, p
ISSN:0002-9610
1879-1883
DOI:10.1016/j.amjsurg.2016.04.008