الفهرس 
Prognostic significance of Intraoperative peritoneal lavage cytology in patients with colorectal cancer
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Abstract
Objective: In this work, we aim to evaluate the impact of detecting free malignant cells in peritoneal fluid on survival and local recurrence and to estimate the incidence of peritoneal carcinomatosis (PC) during follow up. Summary Background Data: Colorectal cancer (CRC) accounts for over 8% of all deaths each year with 1.2 million new cases diagnosed annually worldwide. It represents the 7th commonest cancer in Egypt. Early detection of peritoneal metastasis is a major challenge in such cases. It helps the decision of immediate application of intraperitoneal chemotherapy after resection. Meta-analysis studies reported contrast evidence for a possible prognostic role of intraperitoneal free cancer cells (IPCC) in peritoneal recurrence and survival after curative resection. Methods: Intra-operative peritoneal lavage was performed on 96 Egyptian CRC patients who underwent curative resection to detect IPCC by conventional cytology. Patients with no residual tumor after surgery and no evidence of PC were followed-up for a median 14 months. Results: Our results showed the prevalence of IPCC in the peritoneal lavage was 11.5%. The cumulative overall survival rate at 12 months for patients with IPCC was 100% versus 85% for patients with negative cytology. Peritoneal recurrence occurred in six patients (6.7%) and local recurrence was in four patients (4.4%). Both peritoneal recurrence and local recurrence occurred more in patients with cytology positive lavage than negative ones ( 9.1% vs 6.3%) and ( 9.1% vs 3.8%) respectively, although both were statistically nonsignificant, while Distant metastasis occurred in patients with cytology positive more than patients with cytology negative ( 45.5 % vs 8.9 %) & was statistically significant (p value < 0.001). Conclusions: Positive peritoneal lavage cytology couldn{u2019}t predict the development of recurrence. but it can predict the development of distant Metastasis, IPCC was not independent prognostic factor that didn{u2019}t affect OS & DFS