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

  • Published : 2014.11.28

Abstract

Purpose: To evaluate the prognostic impact of peritoneal washing cytology in patients with endometrial and ovarian cancers. Materials and Methods: We retrospectively identified 86 individuals with ovarian carcinomas, ovarian borderline tumors and endometrial adenocarcinomas. The patients had been treated at Shahid Sadoughi Hospital and Ramazanzadeh Radiotherapy Center, Yazd, Iran between 2004 and 2012. Survival differences were determined by Kaplan-Meier analysis. Multivariate analysis was performed using the Cox regression method. A p<0.05 value was considered statistically significant. Results: There were 36 patients with ovarian carcinomas, 4 with borderline ovarian tumors and 46 with endometrial carcinomas. The mean age of the patients was $53.8{\pm}15.2years$. In patients with ovarian carcinoma the overall survival in the negative cytology group was better than the patients with positive cytology although this difference failed to reach statistical significance (p=0.30). At 0 to 50 months the overall survival was better in patients with endometrial adenocarcinoma and negative cytology than the patients with positive cytology but then it decreased (p=0.85). At 15 to 60 months patients with FIGO 2009 stage IA-II endometrial andocarcinoma and negative peritoneal cytology had a superior survival rate compared to 1988 IIIA and positive cytology only, although this difference failed to reach statistical significance(p=0.94). Multivariate analysis using Cox proportional hazards model showed that stage and peritoneal cytology were predictors of death. Conclusions: Our results show good correlation of peritoneal cytology with prognosis in patients with ovarian carcinoma. In endometrial carcinoma it had prognostic importance. Additional research is warranted.

References

  1. Abiko K, Mandai M, Hamanishi J, et al (2013). PD-L1 on tumor cells is induced in ascites and promotes peritoneal dissemination of ovarian cancer through CTL dysfunction, Clin Cancer Res, 19, 1363-74. https://doi.org/10.1158/1078-0432.CCR-12-2199
  2. Acs G (2005). Serous and mucinous borderline low malignant potential) tumors of the ovary. Am J Clin Pathol, 123, 13-57.
  3. Anastasiadis P, Koutlaki N, Liberis V, et al (2011). The contribution of rapid intraoperative cytology in the evaluation of endometrial cancer spread. Ann Acad Med Singapore, 40, 80-3.
  4. Aoki Y, Kase H, Watanabe M, et al (2001). Stage III endometrial cancer: Analysis of prognostic factors and failure patterns after adjuvant chemotherapy. Gynecol Oncol, 83, 1-5. https://doi.org/10.1006/gyno.2001.6321
  5. Arab Maliheh, Giti Noghabaei, Seyyedeh Neda Kazemi (2014). Comparison of crude and age-specific incidence rates of breast, ovary, endometrium and cervix cancers in Iran. Asian Pac J Cancer Prev, 15, 2461-4. https://doi.org/10.7314/APJCP.2014.15.6.2461
  6. Cooke EW, Pappas L, Gaffney DK (2011). Does the revised international federation of gynecology and obstetrics staging system for endometrial cancer lead to increased discrimination in patient outcomes. Cancer, 117, 4231-7. https://doi.org/10.1002/cncr.26030
  7. Creasman WT, Rutledge F (1971). The prognostic value of peritoneal cytology in gynecologic malignant disease. Am J Obstet Gynecol, 110, 773-81.
  8. Garg G, Gao F, Wright JD, et al (2013). Positive peritoneal cytology is an independent risk-factor in early stage endometrial cancer, Gynecol Oncol, 128, 77-82. https://doi.org/10.1016/j.ygyno.2012.09.026
  9. Giordano G, Varotti E, Brigati F, Berretta R (2014). The value of peritoneal washing cytology during intra-abdominal surgery for female genital tract neoplasms. Clin Genitourin Cancer, 12, 95-101. https://doi.org/10.1016/j.clgc.2013.11.010
  10. Hirai Y, Takeshima N, Kato T, Hasumi K (2001). Malignant potential of positive peritoneal cytology in endometrial cancer. Obstet Gynecol, 97, 725-8. https://doi.org/10.1016/S0029-7844(01)01325-4
  11. Kadar N, Homesley HD, Malfetano JH (1992). Positive peritoneal cytology is an adverse factor in endometrial carcinoma only if there is other evidence of extrauterine disease. Gynecol Oncol, 46, 145-9. https://doi.org/10.1016/0090-8258(92)90246-F
  12. Kasamatsu T, Onda T, Katsumata N, et al (2003). Prognostic significance of positive peritoneal cytology in endometrial carcinoma confined to the uterus. Br J Cancer, 88, 245-50.
  13. Kato T, Watari H, Endo, D, et al (2012). New revised FIGO 2008 staging system for endometrial cancer produces better discrimination in survival compared with the 1988 staging system. J Surg Oncol, 106, 938-41. https://doi.org/10.1002/jso.23203
  14. Keettel WC, Elkins HB (1956). Experience with radioactive colloidal gold in the treatment of ovarian carcinoma. Am J Obstet Gynecol, 71, 553-68.
  15. Lazarov N, Lazarov L, Lazarov S (2013). Role of ascites and peritoneal cytology as prognostic factor for patients with early epithelial ovarian cancer. Trakia J Sci, 4, 359-61.
  16. Lewin SN, Herzog TJ, Barrena Medel NI, et al (2010). Comparative performance of the 2009 international Federation of gynecology and obstetrics' staging system for uterine corpus cancer. Obstet Gynecol, 116, 1141-9. https://doi.org/10.1097/AOG.0b013e3181f39849
  17. Mazurka JL, Krepart GV, Lotocki RJ (1988). Prognostic significance of positive peritoneal cytology in endometrial carcinoma. Am J Obstet Gynecol, 158, 303-6. https://doi.org/10.1016/0002-9378(88)90143-3
  18. Morrow CP, Bundy BN, Kurman RJ, et al (1991). Relationship between surgical-pathological risk factors and outcome in clinical stage I and II carcinoma of the endometrium: a gynecologic oncology group study. Gynecol Oncol, 40, 55-65. https://doi.org/10.1016/0090-8258(91)90086-K
  19. Obermair A, Geramou M, Tripcony L, et al (2001). Peritoneal cytology: impact on disease-free survival in clinical stage I endometrioid adenocarcinoma of the uterus. Cancer Lett, 164, 105-10. https://doi.org/10.1016/S0304-3835(00)00722-9
  20. Preyer O, Obermair A, Formann E, et al (2002). The impact of positive peritoneal washings and serosal and adnexal involvement on survival in patients with stage IIIA uterine cancer. Gynecol Oncol, 86, 269-73. https://doi.org/10.1006/gyno.2002.6744
  21. Rodriguez EF, Monaco SE, Khalbuss W, Austin RM, Pantanowitz L (2013). Abdominopelvic washings: a comprehensive review. Cyto J, 10, 7.
  22. Sneige N, Thomison JB, Malpica A, et al (2012). Peritoneal washing cytologic analysis of ovarian serous tumors of low malignant potential to detect peritoneal implants and predict clinical outcome. Cancer Cytopathol, 120, 238-44. https://doi.org/10.1002/cncy.21219
  23. Takeshima N, Nishida H, Tabata T, Hirai Y, Hasumi K. (2001), Positive peritoneal cytology in endometrial cancer: enhancement of other prognostic indicators. Gynecol Oncol, 82, 470-3. https://doi.org/10.1006/gyno.2001.6301
  24. Tognon G, Carnazza M, Ragnoli M, et al (2013). Prognostic factors in early-stage ovarian cancer. Ecancermed Sci, 7, 325.
  25. Turner DA, Gershenson DM, Atkinson N, Sneige N, Wharton AT (1989). The prognostic significance of peritoneal cytology for stage I endometrial cancer. Obstet Gynecol, 74, 775-80.
  26. Ulla-Maija Haltia, Ralf Butzow, Arto Leminen, Mikko Loukovaara (2014). FIGO 1988 versus 2009 staging for endometrial carcinoma: a comparative study on prediction of survival and stage distribution according to histologic subtype. J Gynecol Oncol, 25, 30-5. https://doi.org/10.3802/jgo.2014.25.1.30
  27. Walker JL, Piedmonte MR, Spirtos NM, et al (2012). Recurrence and survival after random assignment to laparoscopy versus laparotomy for comprehensive surgical staging of uterine cancer: gynecologic oncology group LAP2 study. J Clin Oncol, 30, 695-700. https://doi.org/10.1200/JCO.2011.38.8645
  28. Wei-Na Wan, Yi-Xia Zhang, Xue-Mei Wang, et al (2014). ATAD2 is highly expressed in ovarian carcinomas and indicates poor prognosis. Asian Pac J Cancer Prev, 15, 2777-83. https://doi.org/10.7314/APJCP.2014.15.6.2777
  29. Yildirim M, Suren D, Yildiz M, et al (2013). Tumor markers inperitoneal lavage fluid - contribution to cytology. Asian Pac J Cancer Prev, 14, 1027-30 https://doi.org/10.7314/APJCP.2013.14.2.1027
  30. Zaino RJ (2009). FIGO Staging of endometrial adenocarcinoma:a critical review and proposal. Int J Gynecol Pathol, 28, 1-9. https://doi.org/10.1097/PGP.0b013e3181846c6d