A prospective study on the prognostic value of cytology and tumour markers (CEA and CA19-9) in peritoneal washings of patients with periampullary tumours

Casper van Eijck, S.O.L. Muller, D.C.M. Meyer, Albert Toorenenbergen, W.C.J. Hop, J.H. van Dam, J. Jeekel

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Abstract

Background
Peritoneal metastases and local recurrence continue to be the most frequent type of recurrent disease in pancreatic cancer patients. Microscopic dissemination of cancer cells from the primary tumour is likely to be present before resection or could result from the resection itself.
Methods
Fifty patients with either primary ductal adenocarcinoma of the pancreas (n = 43) or tumour of the ampulla of Vater and distal common bile duct (n = 7) underwent an exploratory laparotomy. Resectability of the tumour and peritoneal metastases at the time of the operation were documented. Cytology and tumour marker levels of CEA and CA19-9 were determined in two peritoneal washings. The first washing was performed before resection of the tumour, the second after resection.
Results
The tumour markers CEA and CA19-9 in the first peritoneal washing were both found to be independent predictors regarding resectability (p < 0.005). Conventional cytology predicted irresectability in only 60% of cases. A significant difference between the two washings, pre- and postresection, was found for both tumour marker levels. Postresection tumour marker levels correlated with tumour recurrence and survival (p < 0.02).
Discussion
Combined levels of CEA and CA19-9 have the best predictive value regarding resectability, tumour recurrence and survival. The results from this study support the theory of preoperative tumour cell seeding and peroperative tumour spill.
Original languageEnglish
Pages (from-to)75-81
Number of pages7
JournalHPB
Volume2
Issue number2
DOIs
Publication statusPublished - 2000

Bibliographical note

© 2000 Isis Medical Media Ltd.

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  • EMC MM-03-47-06-A
  • EMC NIHES-01-64-03

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