J Gynecol Oncol.  2014 Apr;25(2):90-96. 10.3802/jgo.2014.25.2.90.

The relationship between positive peritoneal cytology and the prognosis of patients with FIGO stage I/II uterine cervical cancer

• Kuji S
• Hirashima
• Komeda S
• Tanaka A
• Abe M
• Takahashi
• Takekuma M

• KMID: 1708330
• DOI: http://doi.org/10.3802/jgo.2014.25.2.90

Abstract

OBJECTIVE
The purpose of this study was to assess whether peritoneal cytology has prognostic significance in uterine cervical cancer.
METHODS
Peritoneal cytology was obtained in 228 patients with carcinoma of the uterine cervix (International Federation of Gynecology and Obstetrics [FIGO] stages IB1-IIB) between October 2002 and August 2010. All patients were negative for intraperitoneal disease at the time of their radical hysterectomy. The pathological features and clinical prognosis of cases of positive peritoneal cytology were examined retrospectively.
RESULTS
Peritoneal cytology was positive in 9 patients (3.9%). Of these patients, 3/139 (2.2%) had squamous cell carcinoma and 6/89 (6.7%) had adenocarcinoma or adenosquamous carcinoma. One of the 3 patients with squamous cell carcinoma who had positive cytology had a recurrence at the vaginal stump 21 months after radical hysterectomy. All of the 6 patients with adenocarcinoma or adenosquamous carcinoma had disease recurrence during the follow-up period: 3 with peritoneal dissemination and 2 with lymph node metastases. There were significant differences in recurrence-free survival and overall survival between the peritoneal cytology-negative and cytology-positive groups (log-rank p<0.001). Multivariate analysis of prognosis in cervical cancer revealed that peritoneal cytology (p=0.029) and histological type (p=0.004) were independent prognostic factors.
CONCLUSION
Positive peritoneal cytology may be associated with a poor prognosis in adenocarcinoma or adenosquamous carcinoma of the uterine cervix. Therefore, the results of peritoneal cytology must be considered in postoperative treatment planning.

Keyword

Peritoneal cytology; Prognosis; Radical hysterectomy; Uterine cervical cancer

MeSH Terms

Adenocarcinoma
Carcinoma, Adenosquamous
Carcinoma, Squamous Cell
Cervix Uteri
Female
Follow-Up Studies
Gynecology
Humans
Hysterectomy
Lymph Nodes
Multivariate Analysis
Neoplasm Metastasis
Obstetrics
Prognosis*
Recurrence
Retrospective Studies
Uterine Cervical Neoplasms*

Figure

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  Fig. 1 Recurrence-free survival and overall survival in patients with stage IB to IIB cervical cancer according to the results of peritoneal cytology.

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  Fig. 2 Recurrence-free survival and overall survival in patients with stage IB to IIB adenocarcinoma or adenosquamous carcinoma of the uterine cervix according to the results of peritoneal cytology.

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