Does fluid hysteroscopy increase the stage or worsen the prognosis in patients with endometrial cancer?

Cuesta, Ricardo Sáinz de la; Espinosa, José Angel; Crespo, E; Granizo, Juan José; Rivas, Francisca

doi:10.1016/j.ejogrb.2004.01.029

Cited by 43 publications

(15 citation statements)

References 22 publications

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“…Overall, there seems to be a slightly increased risk of positive peritoneal cytologic findings associated with the use of hysteroscopy (OR, 1.78; CI, 1.13-2.79) 95 (Class 1b). However, available high-quality evidence suggests that the prognosis associated with a hysteroscopic diagnosis of endometrial cancer is not different from that with other diagnostic methods 93 (Class 1b), 92,[96][97][98] (Class 3).…”

Section: Hysteroscopy With Curettage and Directed Biopsymentioning

confidence: 98%

Investigation of Women with Postmenopausal Uterine Bleeding: Clinical Practice Recommendations

Munro

2014

TPJ

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Section: Hysteroscopy With Curettage and Directed Biopsymentioning

confidence: 98%

Investigation of Women with Postmenopausal Uterine Bleeding: Clinical Practice Recommendations

Munro

2014

TPJ

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“…Some scholars considered that the prognosis was unaffected by PC positivity if the patient had no other metastases. 37 , 38 Revel et al 29 reviewed the literature on Medline about the risk of hysteroscopy in EC patients from 1980 to 2001 and concluded that there was as yet no confirmation that the endometrial cells in the peritoneum are washed by the uterine lavage fluid, and no prospective randomized trial has confirmed that hysteroscopy causes cancer spread. In addition, Revel et al 29 found it difficult to determine any difference in EC patients' prognosis between those who underwent hysteroscopy and those who underwent other traditional examinations such as D&C. We summarized recent studies on the abdominal dissemination of EC that might be caused by hysteroscopy and found that, in general, PC positivity had a prognostic significance only in EC patients with extrauterine metastases; otherwise, it would not affect patient survival.…”

Section: Discussionmentioning

confidence: 99%

Fertility Preserved Hysteroscopic Approach for the Treatment of Stage Ia Endometrioid Carcinoma

Wang

et al. 2017

Int J Gynecol Cancer

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ObjectiveThis study aims to explore the feasibility of a hysteroscopic procedure combined with progestin therapy in young patients with stage Ia endometrioid carcinoma (EC) to avoid sterilization.Materials and MethodsEleven young women with stage Ia EC (International Federation of Gynecology and Obstetrics grade 1) who were treated with a hysteroscopic approach combined with progestin from July 2004 to June 2016 were retrospectively analyzed and followed up to monitor their general recovery and pregnancy outcome.ResultsThe patients' median age was 27.3 years (range, 25–39 years). Comorbidities consisted of primary infertility in 8 patients, polycystic ovary syndrome in 4, uterine fibroids in 2, and diabetes in 1. The results of immunohistochemical analysis were positive for all estrogen and progestin receptors. After treatment, 9 patients attained complete remission, and 2 patients achieved partial remission. The results of peritoneal cytology in 4 patients were negative. As of this writing, 6 of the 11 patients have given birth to 7 infants, and 1 patient had an ectopic pregnancy. Two patients ultimately underwent radical resection. The average follow-up time was 82.3 months (range, 15 to 152 months), and all patients remain disease-free.ConclusionsHysteroscopic surgery combined with progestin treatment for stage Ia EC in young patients to avoid sterilization was practical and may represent a new option for patients with stage Ia EC who wish to preserve their fertility.

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“…Several studies of diagnostic hysteroscopy in patients with endometrial cancer showed that the risk of positive peritoneal cytologic results was increased in patients undergoing preoperative hysteroscopy, but there was no significant difference in survival rates according to the peritoneal cytologic results. 26,27 We identified 2 patients with positive cytologic results in this study, and both were suspected to have advanced stage disease on preoperative assessment. They were found to have FIGO stage IIIC and IVB disease after surgery, and there were no upstaging diseases.…”

Section: Discussionmentioning

confidence: 99%

Value of Sonohysterography in Preoperative Assessment of Myometrial Invasion for Patients With Endometrial Cancer

Chang

Lee

Kim

et al. 2010

Journal of Ultrasound in Medicine

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Objective. The aims of this study were to compare the diagnostic performance of sonohysterography (SH) with that of magnetic resonance imaging (MRI) in estimation of myometrial invasion and to evaluate the influence of SH on peritoneal cytologic results for patients with endometrial cancer. Methods. Seventy-four patients with endometrial cancer were included. Sonohysterography and MRI were performed before surgery. All patients had complete staging procedures, including peritoneal cytologic analyses. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were determined for SH and MRI. Results. The concordance rates of myometrial invasion for SH and MRI were 82.4% and 81.1%, respectively. The sensitivity, specificity, PPV, and NPV for identification of deep myometrial invasion were 64.7%, 87.7%, 61.1%, and 89.3% on SH and 70.6%, 84.2%, 57.1%, and 90.6% on MRI. Two patients (2.7%) were found to have positive results for malignant cells on peritoneal cytologic analyses. Conclusions. Sonohysterography appears to be a useful preoperative method for predicting myometrial invasion, comparable to MRI.

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Does fluid hysteroscopy increase the stage or worsen the prognosis in patients with endometrial cancer?

Cited by 43 publications

References 22 publications

Investigation of Women with Postmenopausal Uterine Bleeding: Clinical Practice Recommendations

Investigation of Women with Postmenopausal Uterine Bleeding: Clinical Practice Recommendations

Fertility Preserved Hysteroscopic Approach for the Treatment of Stage Ia Endometrioid Carcinoma

Value of Sonohysterography in Preoperative Assessment of Myometrial Invasion for Patients With Endometrial Cancer

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