The Relationship between Positive Peritoneal Cytology and the Prognosis of Patients with Uterine Cervical Cancer

Abstract

Objective: We investigated the association of positive peritoneal cytology with prognosis in uterine cervical cancer. Study Design: We reviewed the medical records and cytologic materials of 225 Japanese patients with FIGO IB1-IVB uterine cervical cancer who had undergone surgery at our University Hospital between 1993 and 2012. Univariate and multivariate regression analyses were performed for statistical analysis. Results: Positive peritoneal cytology was noted in 6 of 225 patients (2.7%). Positive peritoneal cytology was found in 4 of 149 patients (2.6%) with squamous cell carcinoma (SCC) and in 2 of 70 patients (2.8%) with non-SCC (p = 0.9434). The 5-year survival rate of patients with positive peritoneal cytology was significantly lower than that of patients with negative cytology (50 vs. 84.6%, p = 0.001) in univariate survival analysis. However, peritoneal cytology no longer remained significant in multivariate analysis. Conclusion: Although we conclude that positive peritoneal cytology in uterine cervical cancer is a poor prognostic factor, further investigation and multi-institutional studies are necessary.

Significance of Malignant Peritoneal Cytology on the Survival of Women with Early-Stage Cervical Cancer: A Japanese Gynecologic Oncology Group Study

“…The current study validates the results of prior studies in that the presence of malignant cells in pelvic cytology testing at the time of radical hysterectomy is associated with decreased survival in women with early-stage cervical cancer. As prior studies were limited in the sample size (range, 105-448) and the number of malignant peritoneal cytology cases (range, [11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27], the findings from our study, which included a larger patient pool, are more reliable for interpretation of the analysis [6][7][8][9][10].…”

“…There has long been an interest in determining if the presence of malignant cells in the peritoneal cytology is a possible surgical-pathological risk factor in cervical cancer [5]; however, the prognostic significance in women with early-stage cervical cancer has not been well studied [6][7][8][9][10]. Overall, these prior studies have been limited by small sample size, examination of only certain histology types, or have grouped advanced-stage disease together with early-stage disease, leaving the findings difficult to interpret, specifically in the setting of early-stage disease [6][7][8][9][10][11][12][13][14][15][16].…”