Experience with radioactive colloidal gold in the treatment of ovarian carcinoma

Keettel, William C.; Elkins, H.B.

doi:10.1016/0002-9378(56)90482-3

Cited by 71 publications

(28 citation statements)

References 8 publications

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“…Poor distribution of peritoneal washings specimens, infrequent exfoliation of malignant cells, and interpretive errors contribute in this relatively high false negative rate. Cytologic examination of intraoperative peritoneal washings as a means of detecting subclinical metastases was proposed in 1956 by Keettel and Elkins (Keettel WC, Elkins HB, 1956). Subsequently, peritoneal washing cytology has been accepted as part of the surgical work-up of patients with gynecologic malignancies.…”

Section: Discussionmentioning

confidence: 99%

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

Binesh

Akhavan²,

Behniafard³

et al. 2014

Asian Pacific Journal of Cancer Prevention

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Section: Discussionmentioning

confidence: 99%

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

Binesh

Akhavan²,

Behniafard³

et al. 2014

Asian Pacific Journal of Cancer Prevention

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“…This finding, with its implication that there has been a submacroscopic disruption in the tumoral capsule, is certainly not unique to the current study. In 1974, Keetel et al [6] identified malignant cells in the 36.4% of PWs of patients with apparently stage IA tumors (n = 44). More recently, Mathew and Erozan [19] found 3 patients with clinically stage IA or IB ovarian carcinomas that demonstrated positive cytopathology among a large series of 125 patients (2.4%) with gynecologic malignancies.…”

Section: Discussionmentioning

confidence: 99%

“…The PW was introduced as a formal procedure by Keetel and Elkins in 1956 with the stated objective of ‘detecting early spread’ in patients undergoing gynecologic surgery for suspected malignancy [6]. Later, Creasman and Rutledge reported their findings for a cohort of 98 patients with ovarian carcinoma and demonstrated a significant survival benefit at 4 years among those patients with negative cytopathology compared with patients in whose PWs tumor cells were detected [7].…”

Section: Introductionmentioning

confidence: 99%

Significance of Peritoneal Washing Cytopathology in Ovarian Carcinomas and Tumors of Low Malignant Potential: A Quality Control Study with Literature Review

Özkara

2010

Acta Cytologica

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Objective: The author evaluated a consecutive group of peritoneal washings (PWs) performed in the evaluation of adnexal masses to determine whether the conventional histopathologic prognostic parameters significantly affect the tumor detection rate using this procedure. Study Design: Cytopathologic reports from all PWs performed over a 13-year (1996–2008) period in the evaluation of malignant and borderline ovarian tumors were reviewed and correlated with those of the synchronously obtained histopathologic specimens. Tumors of low malignant potential (LMP) were separated for analysis. Statistical significance was determined using the χ² test. Results: In the study, a total of 134 PWs were associated with primary epithelial malignant tumors (n = 114) or tumors of LMP (n = 20) involving the ovary. The positive PW cytopathology rates for clear cell (83.3%), undifferentiated (80.0%), and serous carcinomas (65.7%) were higher than the overall average positive rate (62.3%) for all histopathologic subtypes. In contrast, endometrioid (41.2%) and mucinous (45.5%) carcinomas had markedly lower cytopathology-positive rates than the overall average positive rate (p = 0.118). As expected, PWs were found to be significantly more likely to yield malignant cells in higher-grade (grades II + III, 71.1%, p = 0.002) and higher-stage (stages III + IV) tumors (76.6%, p = 0.000) than in lower-grade (grade I, 38.7%) and lower-stage (stages I + II) tumors (32.4%) and also in tumors with lymph node involvement (72.7%, p = 0.021) than in tumors without lymph node involvement (46.7%) and in bilateral tumors (74.6%, p = 0.004) than in unilateral tumors (42.9%). The positive cytopathology rates for the PWs of the corresponding primary ovarian carcinomas with prominent pleomorphism (81.0%, p = 0.007), with high mitotic score (80.0%, p = 0.006) and solid architecture (72.9%, p = 0.122) were also higher than the overall average positive rate. The overall sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and efficiency for the ovarian carcinoma (n = 114) cases were 72.3, 85, 95.8, 39.5 and 74.6%, respectively. The positive cytopathology rate for the PWs of the serous tumors of LMP (7.1%) was higher than that of the mucinous tumors of LMP (0.0%) and the overall average positive cytopathology rate (5.0%) for the ovarian tumors with LMP. The calculated sensitivity, specificity, PPV, NPV, and efficiency for tumors of LMP were 33.3, 100, 100, 89.5, and 90%, respectively. Conclusion: PW cytopathology results correlate significantly with almost all of the conventional histopathologic prognostic parameters and the cyto-histomorphologic parameters of the corresponding primary ovarian carcinomas. The positive cytopathology rates also differ according to the histopathologic subtypes. False negativity and ‘false positivity?’ was significantly correlated with tumor grade.

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“…9 One routinely performed component of surgical staging is peritoneal washing. Originally described in 1956 for 'detecting early spread' of ovarian cancers, 19 this procedure soon gained widespread use in the evaluation of endometrial cancers as well. The principal purpose of peritoneal washing is the potential detection of occult extra-uterine spread of disease in patients that otherwise would have been considered FIGO stage I (tumor confined to the uterine corpus) or stage II (tumor confined to the uterine corpus and cervix).…”

mentioning

confidence: 99%

Upstaging based solely on positive peritoneal washing does not affect outcome in endometrial cancer

et al. 2005

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Surgical staging of endometrial carcinoma includes the collection of peritoneal washings in the abdomen and pelvis. A positive finding upstages patients to International Federation of Gynecology and Obstetrics stage IIIA. However, the prognostic significance of such an upstaging, and thus the justification for the routine performance of this procedure, is unclear. This 5-year retrospective study was conducted to determine the frequency and prognostic significance of upstaging of endometrial carcinoma based solely on positive washings. The cohort for the study was collected by review of pathology reports of all washings that were performed prior to hysterectomies for suspected endometrial carcinomas over a 5-year period (01/1995-12/ 1999). Cases with positive cytology were selected if there was no grossly apparent intraperitoneal disease, no histologic evidence of extra-uterine tumor and the cases would otherwise have been considered stage I or II (case group). An age-matched control group was selected of stage I and II patients with the same histologic subtypes and negative washings (n ¼ 19). Of 220 endometrial carcinomas, peritoneal washing cytology was abnormal in 19 (8.6%) and was solely responsible for upstaging only 10 patients (4.5% of all cases, eightendometrioid, one-serous, one-mixed; nine stage IA or IB and one stage IIB). Adjuvant therapy was administered in 90% of the case group and 74% of the control group. After a median follow-up of 51 months (case group) and 63 months (control group), we found only a single patient with progression of disease (recurrence, metastases or death) in the control group. It is concluded that abnormal cytology without other evidence of extrauterine disease leads to upstaging of a minority of endometrial carcinoma patients (4.5%), but does not appear to affect their overall outcome. Although this is a small single site study, it raises questions about the value of this procedure in patients with endometrial cancer.

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Experience with radioactive colloidal gold in the treatment of ovarian carcinoma

Cited by 71 publications

References 8 publications

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

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

Significance of Peritoneal Washing Cytopathology in Ovarian Carcinomas and Tumors of Low Malignant Potential: A Quality Control Study with Literature Review

Upstaging based solely on positive peritoneal washing does not affect outcome in endometrial cancer

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