Significance of intraperitoneal cytology in patients undergoing radical hysterectomy.
The incidence and prognostic significance of positive intraperitoneal cytology taken during a radical hysterectomy was reviewed. A prospective study looking at intraperitoneal cytology was conducted by using 400 consecutive radical hysterectomies from January 1988 through June 1996. All selected patients had peritoneal washings performed prior to a radical hysterectomy with pelvic and para-aortic lymphadenectomy. A single pathologist reviewed all cytological and histologic specimens. A total of 400 patients were included in the study. Only 7 of 400 (1.8%) had positive intraperitoneal cytology. Four had squamous cell cancer and 3 had adenocarcinoma. Five had stage IB cervical cancer and the remainder were stage IIA. Three had positive nodes. Six of 7 had tumor size greater than 3 cm. Three of 7 had > 50% invasion and 2 of 7 had lymphovascular space invasion. No other risk factors were present in these specimens. Six of 7 recurred within 18 months of surgery. Recurrences were local or retroperitoneal; none were upper abdomen or intraperitoneal. The incidence of positive peritoneal cytology during radical hysterectomy is 1.8%. The cost of these cytology specimens did not offer an advantage to the current surgical-pathological factors used to determine prognosis and adjuvant therapy.
Estape
R
R
Department of Gynecologic Oncology, University of Miami/Jackson Memorial Hospital, FL 33136, USA.
Angioli
R
R
Wagman
F
F
Madrigal
M
M
Janicek
M
M
Ganjei-Azar
P
P
Penalver
M
M
Averette
H
H
D000230:Adenocarcinoma / Q000532:radiotherapy / Q000556:secondary*; D002294:Carcinoma, Squamous Cell / Q000532:radiotherapy / Q000556:secondary*; D005260:Female; D006801:Humans; D007044:Hysterectomy; D008207:Lymphatic Metastasis; D010051:Ovarian Neoplasms / Q000473:pathology* / Q000532:radiotherapy; D010534:Peritoneal Neoplasms / Q000532:radiotherapy / Q000556:secondary*; D011379:Prognosis; D011446:Prospective Studies; D018714:Radiotherapy, Adjuvant