Jornal de Citologia e Histologia

Prophylactic Strategy for Peritoneal Recurrence after Curative Operation in Pancreatic Cancer

Abstract

Kenichiro Yamamoto, Shinya Shimada, Masafumi Kuramoto, Satoshi Ikeshima, Toshiro Masuda, Kenichi Nakamura, Shinichi Yoshimatsu, Masayuki Urata and Hideo Baba

Even though curative surgery has been performed for patients with pancreatic cancer without peritoneal free cancer cells at laparotomy, many patients die of peritoneal recurrence. The reason for this fact is postulated that the surgical procedure itself could cause spread of cancer cells into peritoneal cavity. To identify the free cancer cells spilled in the peritoneal cavity during the operation, we have established real-time quantitative reverse transcription Polymerase Chain Reaction (RT-PCR) system. Moreover, we have devised Extensive Intraoperative Peritoneal Lavage (EIPL) therapy as a very simple and non-aggressive prophylactic treatment for peritoneal dissemination of gastric cancer patients with peritoneal free cancer cells. In this paper, we review the validity of EIPL therapy navigated by real-time quantitative RT-PCR detecting free cancer cells in the peritoneal cavity during operation, and the effect of this therapy on the survival after curative operations in patients with pancreatic cancer