Is peritoneal cytology a prognostic factor of endometrial cancer confined to the uterus?

Saga, Yasushi; Imai, Manami; Jobo, Toshiko; Kuramoto, Hiroyuki; Takahashi, Kayoko; Konno, Ryo; Ohwada, Michitaka; Suzuki, Mitsuaki

doi:10.1016/j.ygyno.2006.03.003

Cited by 53 publications

(30 citation statements)

References 15 publications

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“…Therefore, evaluation of the relation between PPC and these prognostic factors in EEC is 10 19 necessary to clarify the prognostic significance of peritoneal cytology, which is still required in the current staging system. Many studies found no association between PPC and other prognostic factors in EEC (4,5,7,13). However, others reported a positive correlation between PPC and Grade 3, deep MI and LVSI (11,12).…”

Section: Discussionmentioning

confidence: 99%

“…Some studies have shown a significant association between PPC and survival in patients with surgically staged EEC (3,5,9,10). In a recent study including 14 704 patients extracted from SEER database, PPC was an independent predictor of poor 5-year disease-specific survival in patients diagnosed with Stage 1 or 2 EEC regardless of histologic type (9).…”

Section: Discussionmentioning

confidence: 99%

“…Although this finding suggests that the prognostic significance of PPC depends on the presence of other risk factors (7,8), other studies have reported that PPC is an independent factor for survival in patients with surgically staged EEC (3,5,9,10). Additional studies have addressed the prognostic significance of PPC in terms of its relation to other factors such as grade, MI and LVSI, and the results are conflicting (4)(5)(6)(7)(11)(12)(13)(14). A large-scale study using the Surveillance, Epidemiology and End Results (SEER) database found that the incidence of PPC increased in surgically staged EEC with highrisk factors such as Grade 3, clear cell or serous carcinoma and carcinosarcoma (9).…”

Section: Introductionmentioning

confidence: 88%

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Influence of positive peritoneal cytology on prognostic factors and survival in early-stage endometrial cancer: a systematic review and meta-analysis

Lee

Suh

Kim

et al. 2016

Japanese Journal of Clinical Oncology

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Objective: The prognostic significance of positive peritoneal cytology in patients with early-stage endometrial cancer (Stage 1 or 2) is controversial and perhaps depends on the presence of other factors. The relationship of other prognostic factors with positive peritoneal cytology remains unclear. This study aimed to investigate the association between positive peritoneal cytology and prognostic factors and the influence of positive peritoneal cytology on survival in patients with early-stage endometrial cancer. Methods: We identified 351 articles on the PubMed, Cochrane and Embase databases using a combination of the following search terms: endometrial cancer, endometrial carcinoma, positive peritoneal cytology and positive peritoneal washing. When filtered for studies comparing positive peritoneal cytology with negative peritoneal cytology in early-stage endometrial cancer, 11 retrospective studies met the selection criteria. Meta-analyses were performed using Review Manager 5.3 software. Results: In patients with surgical stage 1 or 2 early-stage endometrial cancer, the incidence of Grade 3 was higher and 5-year overall survival was worse in patients with positive peritoneal cytology compared with negative peritoneal cytology. However, the incidence of Grade 1 was lower in those with positive peritoneal cytology compared with negative peritoneal cytology. In patients with surgical stage 1 early-stage endometrial cancer, the incidence of myometrial invasion ≥1/2 tended to be higher and 5-year progression-free survival was worse in the positive peritoneal cytology group than the negative peritoneal cytology group. However, the incidence of myometrial invasion <1/2 was lower in the positive peritoneal cytology group than the negative peritoneal cytology group. Conclusion: This study demonstrates that positive peritoneal cytology in patients with early-stage endometrial cancer is significantly associated with other prognostic factors and survival, suggesting its potential as a prognostic factor.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 88%

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Influence of positive peritoneal cytology on prognostic factors and survival in early-stage endometrial cancer: a systematic review and meta-analysis

Lee

Suh

Kim

et al. 2016

Japanese Journal of Clinical Oncology

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“…Although a few studies have failed to prove the prognostic significance of positive peritoneal cytology in patients with early stage endometrioid adenocarcinoma (41,42), most studies especially those with large number of patients have confirmed its significance as an independent predictor of survival (43). In addition, several studies have shown that if peritoneal washing becomes positive for malignant cells, outcomes would be the same in women with endometrial cancer otherwise confined to the uterus, as those women with serosal or adnexal metastasis (37,(44)(45)(46).…”

Section: Discussionmentioning

confidence: 99%

Positive Peritoneal Cytology as a Predictor of Prognosis in Early Stage of Endometrioid Adenocarcinoma

Akhavan

Kazemi

Alibakhshi

et al. 2017

Iranian Journal of Cancer Prevention

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“…16 Sem que o significado da sua presença isolada enquanto factor independente esteja estabelecido de modo consensual, os dados apontam para que possa constituir um marcador negativo de prognóstico, reforçando outros indicadores pejorativos. 17 A metastização nos gânglios pélvicos constituiu um factor preditivo de disseminação ganglionar para-aórtica, que se verificou em 29,4% dos casos de gânglios pélvicos positivos. As incidências referidas em publicações anteriores variam largamente entre 32 e 80%, o que parece traduzir a influência do número de gânglios pélvicos invadidos e do padrão patológico de envolvimento nodal.…”

Section: Discussionunclassified

Factores Preditivos de Metastização Ganglionar Retroperitoneal no Cancro do Endométrio

et al. 2014

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Introduction: It has been suggested that a complete staging may be safely omitted in endometrial carcinoma patients at low risk for lymph node metastasis. The purposes of our study were to explore the prognostic significance of pathologic factors for pelvic and paraaortic nodal spread and to validate the Mayo algorithm in order to identify patients in whom lymphadenectomy may be avoided. Material and Methods:We conducted a retrospective review including 208 patients, regarding the evaluation of pathologic variables and nodal metastases. Statistical analysis was performed using the chi-square test, the Fisher exact test and the Student's t-test. Results: Myometrial invasion > 50% (p < 0.001), cervical invasion (p = 0.001), lymphovascular space invasion (p = 0.003) and positive peritoneal cytology (p = 0.03) were significant predictors of retroperitoneal lymph node dissemination. Pelvic lymph node metastases were predictive of positive paraaortic lymph nodes (p < 0.001). Discussion: The Mayo algorithm identified patients without pelvic or paraaortic nodal metastases with a 98.4% negative predictive value (61/62). Myometral invasion ≤ 50% and absence of cervical and lymphovascular invasion presented a negative predictive value of 98.8% (79/80). Conclusion:Although the Mayo criteria predict a very low likelihood of retroperitoneal nodal metastases, the combination of myometral invasion ≤ 50% and absence of cervical or lymphovascular invasion would have safely avoided lymphadenectomy in a larger number of women. Keywords: Endometrial Neoplasms; Lymphatic Metastasis; Lymph Node Excision; Neoplasm Staging; Predictive Value of Tests; Retroperitoneal Space; Portugal. INtRODUÇÃORepresentando a neoplasia ginecológica mais frequente nos países desenvolvidos, o carcinoma do endométrio possui, em Portugal, taxas anuais de incidência e mortalidade cifradas em 10,3 e 1,9 por 100 000 mulheres, respectivamente. Com base na clínica, na histologia e no perfil molecular, descrevem-se dois tipos de carcinoma do endométrio. Responsável por 80% dos casos, o tipo I relaciona--se com condições que configuram um estado prolongado de hiperestrogenismo não contrabalançado (anovulação, nuliparidade, menopausa tardia, administração de tamoxifeno, cirrose hepática), atinge mulheres mais jovens e obesas e corresponde a tumores do tipo endometrióide, bem diferenciados e com melhor prognóstico. O tipo II associa--se a um endométrio atrófico, raramente exibe expressão de receptores hormonais, corresponde a tipos histológicos não endometrióide (células claras, serosos, carcinossarcomas) e cursa com invasão miometrial profunda e metastização ganglionar frequente. Globalmente, o carcinoma do endométrio acomete sobretudo mulheres na sexta e sétima décadas de vida, tendo a sua incidência vindo a aumen-

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Is peritoneal cytology a prognostic factor of endometrial cancer confined to the uterus?

Cited by 53 publications

References 15 publications

Influence of positive peritoneal cytology on prognostic factors and survival in early-stage endometrial cancer: a systematic review and meta-analysis

Influence of positive peritoneal cytology on prognostic factors and survival in early-stage endometrial cancer: a systematic review and meta-analysis

Positive Peritoneal Cytology as a Predictor of Prognosis in Early Stage of Endometrioid Adenocarcinoma

Factores Preditivos de Metastização Ganglionar Retroperitoneal no Cancro do Endométrio

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