Abstract
Second look operations were performed in 29 of 37 patients with ovarian cancer who had treated with anticancer agents. The association of cytologic findings on abdominal washings with their 5-year survival rates was assessed to evaluate their diagnostic value.
The exploratory operations revealed remaining tumors in 18 (62.1%) of the 29 cases. Their 5-year survival rate was 5.5%(1/18). In the rest or 11 (37.9%) patients, any cancerous tissue was not demonstrated grossly or histologically. Cytology of the intraperitoneal washings was negative in 9 of the 11 patients, and positive in 2. The 5-year survival rate was 77.7%(719) with negative cytology, while 2 with positive cytology both died within 5 years.
In patients who responded well to cancer chemotherapy with intraperitoneal cis-platinum, pretherapeutic cytologic examination had revealed about 130 clusters of tumor cells per field. After treatment, the cell clusters markedly decreased both in number and size, and flattened, indicating that tumor cells were losing the tendency to cluster together. In addition, the tumor cells revealed morphologic changes suggestive of degeneration. Second look operations revealed no tumors in their peritoneal cavity, nor did intraperitoneal washings obtained for cytology contain cancer cells. Their clinical outcomes were excellent.
An early decrease in number of cancer cells in the ascitic fluid is the important index of a response to cancer chemotherapy and an excellent prognosis. The absence of cancer cells in intraperitoneal washings coupled with the absence of tumors in the peritoneal cavity is a sign of excellent prognoses.
