Peritoneal washing cytologic analysis of ovarian serous tumors of low malignant potential to detect peritoneal implants and predict clinical outcome

Abstract

Background Patients with ovarian serous tumors of low malignant potential (OSLMP) who have peritoneal implants, especially invasive implants, are at increased risk of developing tumor recurrence. The ability of peritoneal washing (PW) cytology, to detect the presence and type of peritoneal implants has not been adequately investigated, and its prognostic significance is unknown. Methods We retrospectively reviewed records and PW specimens of 101 patients diagnosed with and treated for OSLMP between 1996 and 2010 at The University of Texas MD Anderson Cancer Center. We compared patients’ staging biopsy findings with those of our review of the PWs. Follow-up data were also analyzed. Results Of the 96 patients with staging biopsy results available, 26 (27%) had peritoneal implants (17 noninvasive, 9 invasive), 19 (20%) had endosalpingiosis, and 51 (53%) had negative findings. The PW specimens of 18 of the 26 patients (69%) with peritoneal implants were positive for serous neoplasm, and a correlation was found between cytologic and histologic findings (p < 0.0001). The sensitivity, specificity, positive predictive, and negative predictive values were 69%, 84%, 62% and 88%, respectively. Four of 101 patients had disease recurrence, 3 of these patients had invasive implants and 1 patient had noninvasive implants. None of the patients who had negative staging biopsy findings or endosalpingiosis but PW specimens positive for serous neoplasm developed disease recurrence. Conclusions PW cytology detects the presence of peritoneal implants with moderate accuracy. Long-term studies are needed to determine whether positive PW cytologic findings are an independent predictor of tumor recurrence.

Diagnostic accuracy of intraoperative consultation (frozen section) in borderline ovarian tumours and factors associated with misdiagnosis

“…Peritoneal cytology is an integral part of staging surgery in ovarian cancer (Sneige et al 2012). Five patients had positive peritoneal cytology in the present study.…”

Prognostic Value of Peritoneal Washing Cytology in Gynecologic Malignancies: a Controversial Issue

“…In addition one study showed that the presence of peritoneal implants in ovarian cancers with a low malignant potential demonstrated a high risk of recurrence (Sneige et al, 2012). In another DOI:http://dx.doi.org/10.7314/APJCP.2014.15.21.9405 Peritoneal Washing Cytology in Gynecologic Malignancies involvement (Ellen et al, 2011.…”

Tumour Markers in Peritoneal Washing Fluid - Contribution to Cytology

“…Presence of peritoneal implants in ovarian cancers with a low malignant potential indicates a high risk of recurrence. PWC may be used to establish this risk (Sneige et al, 2012). In our study there was no patient with an ovarian cancer of low malignant potential.…”