• E Cotte, P Peyrat, E Piaton, F Chapuis, M Rivoire, O Glehen, C Arvieux, J-Y Mabrut, J Chipponi, F-N Gilly, and EVOCAPE group.
• Hospices civils de Lyon, Centre Hospitalier Lyon-Sud, Service de chirurgie viscérale et endocrinienne, 69495 Pierre-Bénite Cedex, France. eddy.cotte@chu-lyon.fr
• Eur J Surg Oncol. 2013 Jul 1; 39 (7): 707-14.

AimIn digestive cancers, the prognostic significance of intraperitoneal free cancer cells remains unclear (IPCC). The main objective of this study was to assess the prognostic significance of IPCC in colorectal and gastric adenocarcinoma. The secondary objectives were to evaluate the predictive significance of IPCC for the development of peritoneal carcinomatosis (PC) and to evaluate the prevalence of synchronous PC and IPCC.MethodsThis was a prospective multicentre study. All patients undergoing surgery for a digestive tract cancer had peritoneal cytology taken. Patients with gastric and colorectal cancer with no residual tumour after surgery and no evidence of PC were followed-up for 2 years. The primary end point was overall survival.ResultsBetween 2002 and 2007, 1364 patients were enrolled and 956 were followed-up over 2 years. Prevalence of IPCC was 5.7% in colon cancer, 0.6% in rectal cancer and 19.5% in gastric cancer. The overall 2-year survival rate for patients with IPCC was 34.7% versus 86.8% for patients with negative cytology (p<0.0001). By multivariate analysis, IPCC was not an independent prognostic factor. No relationship between cytology and recurrence was found.ConclusionThe presence of IPCC was not an independent prognostic and didn't add any additional prognostic information to the usual prognostic factors related to the tumour (pTNM and differentiation). Moreover the presence of IPCC detected with this method didn't appear to predict development of PC. Peritoneal cytology using conventional staining doesn't seem to be a useful tool for the staging of colorectal and gastric cancers.Copyright © 2013 Elsevier Ltd. All rights reserved.

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