INCIDENCE OF POSITIVE PERITONEAL CYTOLOGY IN PATIENTS WITH ENDOMETRIAL CARCINOMA ACCORDING TO DIAGNOSTIC PROCEDURE
Objective: To compare the frequency of positive peritoneal washings in endometrial cancer patients after either hysteroscopy (HSC) or dilatation and curettage (D&C).
Materials and methods: We performed a retrospective analysis of 246 patients who underwent either HSC (N = 155) or D&C (N = 91) and were diagnosed with endometrial carcinoma at the University Medical Center Maribor between January 2008 and December 2014. The incidence of positive peritoneal cytology was evaluated in each group.
Results: There was no overall difference in the incidence of positive peritoneal washings after HSC or D&C (HSC = 12.3%; D&C = 13.2%; p = 0.832). However, a detailed analysis of stage I disease revealed significantly higher rates of positive peritoneal washings in the HSC group (HSC = 12.1%; D&C = 3.3%; p = 0.045). Among these patients, there was no difference between both groups considering histologic type, tumor differentiation and time between diagnosis and operation, but a difference in myometrial invasion was noted (chi-square = 7.265; p = 0.026). In spite of the higher percentage of stage I tumors which invaded more than half of the myometrium in the HSC group, the depth of myometrial invasion was not the decisive factor for the higher rate of positive peritoneal washings in these patients (chi-square = 2.672; p = 0.263).
Conclusions: Although the diagnostic procedure did not influence the overall incidence of positive peritoneal washings, HSC was associated with a significantly higher rate of positive peritoneal cytology in stage I endometrial carcinoma compared to D&C.