Lack of prognostic role of pre-and postoperative peritoneal cytology and cytokeratin PCR-expression on local recurrence after curative anterior resection for mid-low rectal cancer

被引:16
作者
Altomare D.F. [1 ]
Tedeschi M. [1 ]
Rotelli M.-T. [1 ]
Bocale D. [1 ]
Piscitelli D. [2 ]
Rinaldi M. [1 ]
机构
[1] General Surgery and Liver Transplantation Unit, Department of Emergency and Organ Transplantation, University Aldo Moro of Bari, 11-70124 Bari, Policlinico, Piazza G Cesare
[2] Department of Human Pathology, University Aldo Moro of Bari, Bari
关键词
Cancer recurrence; Cytokeratin; 20; Peritoneal cancer cells; Rectal cancer; RT-PCR; Thin-prep;
D O I
10.1007/s13304-011-0071-x
中图分类号
学科分类号
摘要
Local recurrence continues to be a major problem in rectal cancer. After cancer removal, detection of viable cancer cells could be useful to identify patients at risk for local recurrence. Thus, aim of the study was the detection of residual peritoneal cancer cells with a possible prognostic role for local recurrence. Twenty-nine patients were operated (R0) for low (extraperitoneal) rectal cancer, without neoadjuvant radiochemotherapy. Before and immediately after cancer removal, a peritoneal lavage was done to evaluate by RT-PCR the cytokeratin 20 mRNA on isolated cells and in order to detect cancer cells by the Thin-prep test. After a median follow-up of 39 months, 5 patients died (17%), one for non-cancer-related disease, two (7%) for local recurrence and peritoneal carcinosis, and two for distant metastases. Preoperative cytology with Thin-prep test was positive in 4 patients (14%), while postoperative peritoneal cytology was positive only in 1 patient, different from the previous. No patient developed local or distal recurrence and all were disease-free at the end of the follow-up. RT-PCR analysis was positive on the peritoneal lavage after cancer removal in 11 patients. One died for unrelated cause and no one developed local recurrences. Local recurrence occurred in only 1 of the 2 patients with positive RT-PCR analysis on the first lavage and negative on the second lavage. Our study demonstrates a not important prognostic role of Thin-prep test and RTPCR of cytokeratin 20 mRNA on the detection of patients at risk for local recurrence after curative resection of rectal cancer. © 2011 Springer-Verlag.
引用
收藏
页码:109 / 113
页数:4
相关论文
共 24 条
[1]
Wong R.K., Tandan V., De Silva S., Figueredo A., Preoperative radiotherapy and curative surgery for the management of localized rectal carcinoma, Cochrane Database Syst Rev Apr, 18, (2007)
[2]
Leong A.F.P.K., Total mesorectal excision (TME) - Twenty years on, Annals of the Academy of Medicine Singapore, 32, 2, pp. 159-162, (2003)
[3]
Williams N.S., Dixon M.F., Johnston D., Reappraisal of the 5 centimetre rule of distal excision for carcinoma of the rectum: A study of distal intramural spread and of patients' survival, British Journal of Surgery, 70, 3, pp. 150-154, (1983)
[4]
Bernstein T.E., Endreseth B.H., Romundstad P., Wibe A., Et al., Circumferential resection margin as a prognostic factor in rectal cancer, Br J Surg, 96, pp. 1348-1357, (2009)
[5]
Jensen L.H., Altaf R., Harling H., Jensen M., Laurberg S., Lindegaard J.C., Muhic A., Vestermark L., Jakobsen A., Bulow S., Et al., Clinical outcome in 520 consecutive Danish rectal cancer patients treated with short course preoperative radiotherapy, Eur J Surg Oncol, 36, pp. 237-243, (2010)
[6]
Hase K., Ueno H., Kuranaga N., Utsunomiya K., Kanabe S., Mochizuki H., Intraperitoneal exfoliated cancer cells in patients with colorectal cancer, Diseases of the Colon and Rectum, 41, 9, pp. 1134-1140, (1998)
[7]
Guller U., Zajac P., Schnider A., Bosch B., Vorburger S., Zuber M., Spagnoli G.C., Oertli D., Maurer R., Metzger U., Harder F., Heberer M., Marti W.R., Disseminated single tumor cells as detected by real-time quantitative polymerase chain reaction represent a prognostic factor in patients undergoing surgery for colorectal cancer, Ann Surg, 236, pp. 768-775, (2002)
[8]
Aoki S., Takagi Y., Hayakawa M., Yamaguchi K., Futamura M., Kunieda K., Saji S., Detection of peritoneal micrometastases by reverse transcriptase- polymerase chain reaction targeting carcinoembryonic antigen and cytokeratin 20 in colon cancer patients, Journal of Experimental and Clinical Cancer Research, 21, 4, pp. 555-562, (2002)
[9]
Yamamoto S., Akasu T., Fujita S., Moriya Y., Long-term prognostic value of conventional peritoneal cytology after curative resection for colorectal carcinoma, Japanese Journal of Clinical Oncology, 33, 1, pp. 33-37, (2003)
[10]
Noura S., Ohue M., Seki Y., Yano M., Ishikawa O., Kameyama M., Long-term prognostic value of conventional peritoneal lavage cytology in patients undergoing curative colorectal cancer resection, Dis Colon Rectum, 52, pp. 1312-1320, (2009)