Prognostic impact of peritoneal cytology in patients with endometrial carcinoma

In 169 patients with all stages of endometrial cancer peritoneal cytology was performed and the finding correlated to the stage of disease, histologic grade, depth of myometrial invasion, tumor site in the uterine cavity, menstrual status, frequency of recurrence and 5-year survival. In 23 (11.6%) patients malignant cells were found in the peritoneal washing. In patients with Stage I endometrial cancer 6.5%, Stage II 9.1%, and in those in whom disease had spread outside the uterus (Stage III and IV) in 68.0% (p < 0.001). Positive peritoneal cytology was found significantly more frequently in patients with maintained menstrual cycle (p < 0.01), patients with tumor localized in uterine horns and in those patients with low values of steroid receptors. With regard to the histologic grade no difference was found in peritoneal cytology regardless of the stage of the disease. With regard to the myometrial invasion difference in the finding of malignant cells was found only in those patients in whom the tumor had spread outside the uterus (p < 0.05). Regardless of the stage of the disease, the frequency of recurrence and 5-year survival did not correlate with the finding of malignant cells in peritoneal lavage. According to our results the finding of peritoneal cytology, as an isolated prognostic factor, or in correlation with other prognostic factors, does not play an important role in the prognosis of patients with endometrial cancer, particularly those in whom the tumor is localized only in the uterus.