Effect of positive peritoneal cytology on the prognosis of patients with FIGO stage I endometrial cancer

Objective: Peritoneal cytology is routinely analyzed during surgical treatment of endometrial cancer. We investigated the effect of positive peritoneal cytology on the prognosis of patients with International Federation of Gynecology and Obstetrics (FIGO) stage I endometrial cancer. Methods: The medical records of 364 patients diagnosed with FIGO stage I endometrial cancer between January 2006 and December 2017 were retrospectively reviewed. Twenty-five patients (6.8%) had positive whereas 339 had negative peritoneal cytology results (93.2%). Demographics, recurrence-free survival, and 5-year overall survival were compared. The clinical factors affecting survival and recurrence were evaluated by univariate and multivariate analyses. Results: The median age was 53 years and median follow-up was 85 months (range, 6–142). There was no significant difference in the demographics and pathologic results between the groups. Recurrence occurred in only one patient with positive peritoneal cytology. The differences in recurrence-free (p = 0.815) and 5-year overall survival (p = 0.938) between the patients with positive and those with negative peritoneal cytology were not significant. In the univariate analysis, lymphovascular invasion (p = 0.030) and non-endometrioid histology (p $<$ 0.001) were significantly associated with an increased recurrence risk, but only non-endometrioid histology was associated with recurrence and reduced survival in the multivariate analysis. Discussion: Positive peritoneal cytology did not seem to be associated with recurrence or overall survival in this series of patients with FIGO stage I endometrial cancer.

Endometrial neoplasm; Multivariate analysis; Peritoneum; Prognosis

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