The Risk of Lymph Node Metastasis With Positive Peritoneal Cytology in Endometrial Cancer. Issue 1 (1st January 2013)

• Record Type: Journal Article
• Authors: Garg, Gunjal; Gao, Feng; Wright, Jason D.; Hagemann, Andrea R.; Zighelboim, Israel; Mutch, David G.; Powell, Matthew A.
• Is Part Of: International journal of gynecological cancer. Volume 23:Issue 1(2013)
• Page Start: 90
• Page End: 97
• Publication Date: 2013-01-01
• Subjects: Peritoneal cytology -- Lymph node -- Metastasis -- Endometrial cancer; Generative organs, Female -- Cancer -- Periodicals; 616.99465
• DOI: 10.1097/IGC.0b013e318275afd2
• Languages: English
• ISSNs: 1048-891X

Abstract

Abstract : Objective: To determine the correlation between positive peritoneal cytology (PPC) and lymph node metastasis in patients with endometrial cancer grossly confined to the uterus. Methods: Data were extracted from the Surveillance, Epidemiology, and End Results database between 1988 and 2005. Only patients with endometrial cancer grossly confined to the uterus who had undergone a complete staging procedure (lymph node removal) were included. Statistical analysis used the χ 2 test and logistic regression models. Results: A total of 22, 947 patients were identified. Positive peritoneal cytology was present in 3.5% of the patients. The incidence of lymph node metastasis was significantly higher among patients with PPC compared to those with negative peritoneal cytology for all histologic types examined ( P < 0.0001): endometrioid adenocarcinoma, 28.7% versus 6.9%; adenocarcinoma not otherwise specified, 35.4% versus 5.8%; clear cell/serous carcinoma, 41.4% versus 19.0%, and carcinosarcoma, ; 38.4% versus 14.4%. After adjusting for other contributing factors in the multivariable model, PPC remained an independent predictor of lymph node metastasis ( P < 0.0001). Conclusion: Our data indicate that patients with positive washings are at significant risk of nodal metastasis and adverse prognosis. Although no longer a part of the current International Federation of Gynecology and Obstetrics staging criteria, peritoneal cytology status should continue to inform clinical decision making in endometrial cancer.