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Case report
Conversion surgery for positive peritoneal washing cytology in pancreatic cancer
  1. Katsutaka Mitachi,
  2. Kyohei Ariake,
  3. Fuyuhiko Motoi and
  4. Michiaki Unno
  1. Department of Surgery, Tohoku University, Sendai, Japan
  1. Correspondence to Professor Michiaki Unno; m_unno{at}


Positive peritoneal washing cytology (PPC) of pancreatic carcinoma is defined as distant metastasis in the American Joint Committee on Cancer or Union for International Cancer Control’s tumour, node, metastases classification. However, surgical resection was believed to be the only method that prolong survival; thus, many institutions perform pancreatectomy for PPC, despite the unfavourable prognosis. Therefore, a more preferable alternative treatment for PPC is required. A 64-year-old man with resectable pancreatic tail cancer presented to our hospital. PPC was detected at first laparotomy; thus, pancreatectomy was avoided and gemcitabine with nabpaclitaxel (GnP) was administered. After four courses of GnP treatment, PPC converted to negative, as evaluated by abdominal port cytology. Thus, distal pancreatectomy was performed, and R0 resection was achieved. He has been healthy for more than 24 months since the first laparotomy. Initial chemotherapy with the intention of converting the cytological status followed by surgical treatment might become a useful treatment strategy for PPC.

  • pancreatic cancer
  • surgical oncology
  • pancreas and biliary tract

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  • Contributors KM and KA wrote the manuscript and prepared the figures. FM and MU reviewed and rewrote the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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