IMR Press / EJGO / Volume 42 / Issue 6 / DOI: 10.31083/j.ejgo4206164
Open Access Original Research
Prognosis of positive peritoneal cytology in minimally invasive surgery for early-stage endometrial cancer
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1 Department of Obstetrics and Gynecology, Yokohama Municipal Citizen’s Hospital, 221-0855 Yokohama, Kanagawa, Japan
2 Department of Obstetrics and Gynecology, Kanazawa University School of Medicine, 920-8641 Kanazawa, Ishikawa, Japan
3 Department of Obstetrics and Gynecology, Tokai University School of Medicine, 259-1193 Isehara, Kanagawa, Japan
Eur. J. Gynaecol. Oncol. 2021 , 42(6), 1124–1129; https://doi.org/10.31083/j.ejgo4206164
Submitted: 9 August 2021 | Revised: 15 October 2021 | Accepted: 26 October 2021 | Published: 15 December 2021
Copyright: © 2021 The Author(s). Published by IMR Press.
This is an open access article under the CC BY 4.0 license (https://creativecommons.org/licenses/by/4.0/).
Abstract

Objective: In this decade, minimally invasive surgery for endometrial cancer has spread rapidly worldwide. This study aimed to evaluate the clinical significance of peritoneal cytology in minimally invasive surgery for early-stage endometrial cancer. Methods: The subjects were patients who underwent minimally invasive surgery for endometrial cancer stages I–III (FIGO2008) between 2014 and 2019. We classified patients into three groups (group A: surgical stage I/II and peritoneal cytology negative, group B: surgical stage I/II and peritoneal cytology positive, and group C: surgical stage III), and examined oncological outcomes retrospectively on the basis of the patients’ medical records. Results: Of the 225 patients, 176, 19, and 30 were classified into groups A, B, and C, respectively. Kaplan–Meier curve analysis with a log-rank test demonstrated that group A had a better progression free survival (PFS) than that of group B (p < 0.0001), and there was no statistical difference in PFS between groups B and C (p = 0.748). Furthermore, group A had a better overall survival than that of group B (p = 0.001), and there was no statistical difference in OS between groups B and C (p = 0.766). In multivariate analyses for PFS in groups A and B, peritoneal cytology, along with lymph-vascular space invasion, were significant poor prognosis factors. Conclusions: Our results suggest that positive peritoneal cytology is a poor prognosis factor in laparoscopic surgery for early-stage endometrial cancer.

Keywords
Endometrial cancer
Peritoneal cytology
Prognostic factor
Laparoscopic surgery
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