Hysteroscopy does not increase the risk of microscopic extrauterine spread in endometrial carcinoma

2003 ◽  
Vol 13 (2) ◽  
pp. 223-227 ◽  
Author(s):  
L. Selvaggi ◽  
G. Cormio ◽  
O. Ceci ◽  
G. Loverro ◽  
A. Cazzolla ◽  
...  
Keyword(s):  
Endometrial Cancer ◽  
Endometrial Carcinoma ◽  
Cancer Patients ◽  
Abdominal Cavity ◽  
Primary Diagnosis ◽  
Peritoneal Cytology ◽  
Clinicopathologic Characteristics ◽  
Diagnostic Modality ◽  
Tumor Dissemination ◽  
Positive Peritoneal Cytology

Fluid hysteroscopy has been suspected to cause tumor dissemination in the abdominal cavity in endometrial cancer patients. The aim of our study was to evaluate the incidence of microscopic extrauterine spread according to diagnostic modality (dilatation & curretage, D&C, hysteroscopy, or both) in patients with endometrial carcinoma. A retrospective study was conducted on 147 patients with histologically proven diagnosis of endometrial carcinoma without macroscopic extrauterine disease. Fluid hysteroscopy was performed by using saline solution irrigated at a final flow of 150 ml/min with a intrauterine pressure ranging between 25 and 50 mmHg. Microscopic intraperitoneal disease and positive peritoneal cytology were considered the primary end-points of this analysis. Fifty-two patients (35%) had diagnosis of endometrial cancer made only by D&C, 56 (39%) underwent D&C and then hysteroscopy, and 39 (26%) had only hysteroscopy. Distribution of the patients in this three groups was casual, and clinicopathologic characteristics of the patients in the three groups were similar. Peritoneal cytology was positive in nine patients, 13 had microscopic ovarian metastases, and eight had microscopic involvement of the pelvic peritoneum or of omentum. Neither the presence of positive peritoneal cytology nor the findings of microscopic intraperitoneal dissemination were significantly associated with the diagnostic procedure employed for primary diagnosis (D&C or D&C plus hysteroscopy or hysteroscopy alone). We conclude that fluid hysteroscopy does not increase the risk of microscopic intraperitoneal spread in endometrial cancer patients as compared to D&C.

scholarly journals Prognostic significance of peritoneal cytology in low-risk endometrial cancer: comparison of laparoscopic surgery and laparotomy

2021 ◽  
Author(s):  
Satoe Fujiwara ◽  
Ruri Nishie ◽  
Shoko Ueda ◽  
Syunsuke Miyamoto ◽  
Shinichi Terada ◽  
...  
Keyword(s):  
Endometrial Cancer ◽  
Laparoscopic Surgery ◽  
Retrospective Study ◽  
Prognostic Significance ◽  
Low Risk ◽  
Peritoneal Cytology ◽  
Chi Square ◽  
Significant Difference ◽  
Chi Square Test ◽  
Positive Peritoneal Cytology

Abstract Background There is uncertainty surrounding the prognostic value of peritoneal cytology in low-risk endometrial cancer, especially in laparoscopic surgery. The objective of this retrospective study is to determine the prognostic significance of positive peritoneal cytology among patients with low-risk endometrial cancer and to compare it between laparoscopic surgery and conventional laparotomy. Methods From August 2008 to December 2019, all cases of pathologically confirmed stage IA grade 1 or 2 endometrial cancer were reviewed at Osaka Medical College. Statistical analyses used the Chi-square test and the Kaplan–Meier log rank. Results A total of 478 patients were identified: 438 with negative peritoneal cytology (232 who underwent laparotomy and 206 who undertook laparoscopic surgery) and 40 with positive peritoneal cytology (20 who underwent laparotomy and 20 who received laparoscopic surgery). Survival was significantly worse among patients with positive peritoneal cytology compared to patients with negative peritoneal cytology. However, there was no significant difference among patients with negative or positive peritoneal cytology between laparoscopic surgery and laparotomy. Conclusion This retrospective study suggests that, while peritoneal cytology is an independent risk factor in patients with low-risk endometrial cancer, laparoscopic surgery does not influence the survival outcome when compared to laparotomy.

Re-thinking the prognostic significance of positive peritoneal cytology in endometrial cancer

2021 ◽  
Vol 161 (1) ◽  
pp. 135-142 ◽  
Author(s):  
Masataka Takenaka ◽  
Misato Kamii ◽  
Yasushi Iida ◽  
Nozomu Yanaihara ◽  
Jiro Suzuki ◽  
...  
Keyword(s):  
Endometrial Cancer ◽  
Prognostic Significance ◽  
Peritoneal Cytology ◽  
Positive Peritoneal Cytology

Does Neoadjuvant Treatment for Gastric Cancer Patients with Positive Peritoneal Cytology at Staging Laparoscopy Improve Survival?

2008 ◽  
Vol 15 (10) ◽  
pp. 2684-2691 ◽  
Author(s):  
Brian Badgwell ◽  
Janice N. Cormier ◽  
Sunil Krishnan ◽  
James Yao ◽  
Gregg A. Staerkel ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Cancer Patients ◽  
Neoadjuvant Treatment ◽  
Staging Laparoscopy ◽  
Peritoneal Cytology ◽  
Positive Peritoneal Cytology ◽  
Gastric Cancer Patients

Impact of surgical approach on prevalence of positive peritoneal cytology and lymph-vascular invasion in patients with early-stage endometrial carcinoma: a National Cancer Database study

2021 ◽  
pp. ijgc-2021-002445
Author(s):  
Dimitrios Nasioudis ◽  
Emily M Ko ◽  
Lori Cory ◽  
Nawar Latif
Keyword(s):  
Minimally Invasive Surgery ◽  
Minimally Invasive ◽  
Endometrial Carcinoma ◽  
Invasive Surgery ◽  
Surgical Approach ◽  
Vascular Invasion ◽  
Early Stage ◽  
Tumor Grade ◽  
Peritoneal Cytology ◽  
Positive Peritoneal Cytology

ObjectiveTo investigate the prevalence of positive peritoneal cytology and lymph-vascular invasion by surgical approach among patients with early stage endometrioid endometrial carcinoma undergoing hysterectomy.MethodsThe National Cancer Database was accessed and patients with FIGO stage I endometrioid endometrial carcinoma (with no history of another tumor diagnosed) who underwent simple hysterectomy (open or minimally invasive) between January 2010 and December 2015 and had available data on the presence of lymph-vascular invasion and/or status of peritoneal cytology were selected for further analysis. The impact of a surgical approach on the odds of lymph-vascular invasion and positive peritoneal cytology was calculated after controlling for tumor grade, size, and depth of myometrial invasion.ResultsA total of 74 732 patients who met the inclusion criteria were identified. The rate of minimally invasive hysterectomy was 75.7%. Data on peritoneal cytology status and lymph-vascular invasion were available for 50 185 and 71 641 patients, respectively. A higher proportion of patients who had minimally invasive hysterectomy had positive peritoneal cytology (4.4% vs 2.3%, p<0.001), and presence of lymph-vascular invasion (10.4% vs 9.2%, p<0.001). After controlling for tumor size, tumor grade, and disease substage, the performance of minimally invasive surgery was associated with higher odds of positive peritoneal cytology (OR 2.08, 95% CI 1.83 to 2.37) and presence of lymph-vascular invasion (OR 1.33, 95% CI 1.25 to 1.41). After controlling for confounders there was no difference in survival between open and minimally invasive surgery groups (HR 0.93, 95% CI 0.85 to 1.004).ConclusionsMinimally invasive surgery may be associated with a higher incidence of positive peritoneal cytology and lymph-vascular invasion among patients with early stage endometrioid endometrial cancer. There was no difference in overall survival between patients who had laparotomy or minimally invasive surgery.

Prospective self-controlled study on prevention of hysteroscopic dissemination in endometrial carcinoma

2004 ◽  
Vol 14 (5) ◽  
pp. 921-926
Author(s):  
K. W. K. Lo ◽  
T. H. Cheung ◽  
S. F. Yim ◽  
M. Y. Yu ◽  
L. Y. S. Chan ◽  
...  
Keyword(s):  
Endometrial Carcinoma ◽  
Previous History ◽  
Uterine Cavity ◽  
Final Analysis ◽  
Controlled Study ◽  
Peritoneal Cytology ◽  
Fallopian Tubes ◽  
Malignant Cells ◽  
Peritoneal Washing ◽  
Positive Peritoneal Cytology

Patients diagnosed to have endometrial carcinoma without prior hysteroscopic examination were recruited from March 2000 to August 2003. Normal saline was used to distend the uterine cavity during the hysteroscopic examination to look for endocervical spread before the definitive surgical treatment. We performed laparotomy, clamped both fallopian tubes, and collected peritoneal washing before the hysteroscopic examination was performed. Peritoneal washing was collected once more after the hysteroscopic examination. Hysteroscopic assessment was performed in 103 patients. Of them, 10 patients were excluded from the study due to previous history of tubal sterilization or blockage. The final analysis was confined to 93 patients. Positive peritoneal cytology was found in 10 (10.8%) patients and this finding was significantly related to the tumor grading (P = 0.023), adnexal involvement (P = 0.003), cervical invasion (P = 0.01), and the presence of peritoneal seedlings (P = 0.001). In five of the 10 patients with positive peritoneal cytology before the hysteroscopic examination, malignant cells could also be recovered in the peritoneal washing collected after the hysteroscopic examination. For patients with negative peritoneal cytology before hysteroscopy, none exhibited positive peritoneal cytology after the procedure. Our data suggested that complete occlusion of both fallopian tubes can effectively prevent the dissemination of endometrial malignant cells into the peritoneal cavity during hysteroscopy.

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