[Long-term prognostic value of positive peritoneal washing in colon cancer]. / Cancerul de colon: valoarea prognostica pe termen lung al lavajului peritoneal pozitiv.

UNLABELLED: We examined the prognostic value of free malignant cells in the peritoneal cavity of patients with colon adenocarcinoma. In 1996-1999, 88 patients underwent peritoneal washing with cytologic analysis immediately before elective colon resection for adenocarcinoma with no evidence of peritoneal metastases. Peritoneal washing fluid was collected before abdominal exploration centrifuged immediately and stained with the May-Grünwald-Giemsa and Harris-Shorr methods. Malignancy was defined as recommended by Papanicolaou. Free malignant cells in peritoneal fluid were found in 25 of 88 (28%) patients (Dukes A 0, of 11, Dukes B 10 of 31, Dukes C 11 of 37, Dukes D 4 of 9). The positive rate was 24 of 75 (32%) among patients with tumors involving the serous layer and 1 of 13 (8%) among the others (p = 0.00989). Positive peritoneal washing was not significantly associated with survival in multivariate analysis. CONCLUSION: The presence of free malignant cells in the peritoneal cavity of patients with colon cancer provided no further prognostic information relative to the Dukes classification in this study. The 5 years survival rates were 48% among patients with positive and negative peritoneal washing respectively (p = 0.09).

[Our experience regarding neoplasms of the extrahepatic bile ducts]. / Experienta noastra în legatura cu neoplasmele cailor biliare extrahepatice si periampulare.

AIMS: We tried to study the cases of extrahepatic bile ducts tumors and to emphasize the main diagnosis methods in therapeutic--efficient phases. MATERIAL AND METHODS: This is a retrospective statistical study of nine years of experience (1993-2001); in this time there were admitted 34 patients diagnosed with neoplasm of the extrahepatic bile ducts and periampular carcinoma. In this study we included patients with malignant tumors of the gallbladder, of the choledocus, with Klatskin's tumor and with cancers of the ampulla of Vater. The patients were between 37 and 83 years old (an average of 64.6 yr.). The sex ratio, M/F, was 1.83/1. RESULTS: The most frequent sites were: the gallbladder (41%), followed by the ampullar carcinomas (26%), Klatskin's tumors (18%) and the tumors of the choledocus (15%). The peak of incidence was found in the eighth life decade (11 cases). The survival in this study group was significantly influenced by the time of the diagnosis. The results of this study confirm once more the severity of these tumors and the major difficulties of the early diagnosis. CONCLUSIONS: The only chance for a significant survival in these patients is offered by an early diagnosis. The therapeutical options are centered by the extended resection of the tumors. The prognosis is darkened by the advanced degree of evolution in the moment of the diagnosis.