Is peritoneal cytology a predictor of unresectability in pancreatic carcinoma?
GROUND/AIMS: Demonstration of unresectability often requires diagnostic laparotomy with high co-morbidity in pancreatic carcinoma. The value of detected peritoneal tumor cells and influence on outcome should be determined. METHODOLOGY: In a prospective study 150 consecutive patients with pancreatic carcinoma were evaluated. Improvement of diagnostic accuracy in diagnosing unresectability was calculated for combination of CT, endoscopic ultrasonography and peritoneal cytology. RESULTS: Unexpected subglissonian metastases were found in 10%. 87 patients with peritoneal washings were included in the study, 20 patients with detected peritoneal tumor cells (n=22) were inoperable. In all patients of this group the ventral integrity of pancreas was damaged. In 23 patients with preoperative existent ascites, only in 4 cases could peritoneal tumor cells be detected. In patients with positive cytology together with disrupted ventral pancreatic margin as predictors of unresectability, sensitivity
