Author/Authors :
ALIBAKHSHI ABBAS نويسنده , Mousavi Azamsadat نويسنده Department of gynecologic oncology, Tehran University of Medical Sciences, Tehran, Iran. Mousavi Azamsadat , Modaresgilani Mitra نويسنده Gynecology Oncology Department, Vali-Asr Hospital, Tehran University of Medical Sciences, Tehran, Iran , Akhavan Setare نويسنده Department Gynecology Oncology, Iran University of Medical Sciences, Tehran, Iran , Kazemi Zohre نويسنده Department of Gynecologic Oncology, Imam Khomeini
Hospital, Tehran University of Medical Sciences, Tehran, IR
Iran , Ahmadzadeh Azar نويسنده Department of Gynecologic Oncology, Imam Khomeini
Hospital, Tehran University of Medical Sciences, Tehran, IR
Iran , Rezaie Kahkhayi Khadije نويسنده Department of Gynecologic Oncology, Imam Khomeini
Hospital, Tehran University of Medical Sciences, Tehran, IR
Iran
Abstract :
Background Peritoneal cytology has been reported to be an
independent risk factor for poor survival, but it is not included in the
current international federation of gynecology and obstetrics (FIGO)
staging system for risk stratification. Objectives We aimed to
investigate the prognostic significance of positive peritoneal cytology
(PPC) in patients with early stage endometrioid adenocarcinoma. Methods
Medical profiles of patients with uterine carcinoma referring to Imam
Khomeini hospital and Mirza Koochak Khan hospital between September,
2005 and December, 2011 have been reviewed. Patients had a complete
staging procedure and peritoneal cytology evaluation. Results Among 220
patients with mean age of 56.3 ± 9.1 years, 204 were Negative for
peritoneal cytology (NPC) and 16 showed PPC. In the group of patients
with endometrioid adenocarcinoma, 125 were in stage I and 32 were in
stage II. Univariate analysis on patients with endometrioid
adenocacinoma revealed that stage II (OR = 7.12, 95% CI = 2.95-22.10, P
value < 0.001), stage III (OR = 8.04, 95% CI = 2.14 - 30.09, P
value < 0.001), stage IV (OR = 58.09, 95% CI = 13.74 - 245.66, P
value < 0.001), recurrence of either intra (OR = 32.65, 95% CI =
12.2 - 86.7, P value < 0.001) or extra pelvic (OR = 14.54, 95% CI
= 4.4 - 47.7, P value < 0.001), and the number of lymph nodes
involvement (OR = 5.59, 95% CI = 2.5 - 12.51, P value < 0.001)
were significantly associated with survival. Also, patients with PPC had
significantly poorer survival compared to those with negative peritoneal
cytology; 38% Vs 88% were alive after 5 years (P value < 0.0001).
Mean 5-year survival in PPC and NPC patients were 3.31 years and 4.74
years, respectively. Conclusions Our study demonstrated that positive
peritoneal cytology is an independent prognostic factor in patients with
early stage endometrioid adenocarcinoma. We propound that peritoneal
cytology adds back into the future FIGO staging criteria revision. Until
then, peritoneal washings should still be considered as an important
part for accurate risk-stratification.
