[Feasibility of peritoneal washing cytology through the totally implanted reservoir for early detection of peritoneal recurrence of ovarian cancer]

Abstract

There have been no reliable ways to follow up ovarian cancer patients receiving optimal debulking. In this study, we assessed the feasibility of cytological diagnosis on peritoneal washing cells collected through a totally implanted reservoir as a tool in following up these patients. Between 1988 and 1993, 31 patients underwent optimal debulking and were implanted with a reservoir. After the operation, the patients were followed up at 2-4 week intervals with peritoneal washing cytology. Six patients were diagnosed as having a recurrence by the peritoneal washing cytology alone. And at this point there had been no other positive findings by other conventional methods. There were no complications caused by reservoirs. Activated mesothelial cells, multinucleated histiocytes and hemosiderine-laden histiocytes were characteristic cytologic findings accompanying adenocarcinoma cells. Hemosiderin-laden histiocytes were found by peritoneal washing cytology even before the appearance of adenocarcinoma cells. The appearance of hemosiderin-laden histiocytes may therefore be a sign of intraperitoneal recurrence of ovarian cancer.

Conclusion: 1) Peritoneal washing cytology through a reservoir is useful for early detection of intraperitoneal recurrence of optimally debulked ovarian cancer without any significant complications. 2) The appearance of intraperitoneal hemosiderin-laden histiocytes may be sign of intraperitoneal recurrence of ovarian cancer.