Prognosis of positive peritoneal cytology in minimally invasive surgery for early-stage endometrial cancer

Objective: In this decade, minimally invasive surgery for endometrial cancer has spread rapidly worldwide. This study aimed to evaluate the clinical significance of peritoneal cytology in minimally invasive surgery for early-stage endometrial cancer. Methods: The subjects were patients who underwent minimally invasive surgery for endometrial cancer stages I–III (FIGO2008) between 2014 and 2019. We classified patients into three groups (group A: surgical stage I/II and peritoneal cytology negative, group B: surgical stage I/II and peritoneal cytology positive, and group C: surgical stage III), and examined oncological outcomes retrospectively on the basis of the patients’ medical records. Results: Of the 225 patients, 176, 19, and 30 were classified into groups A, B, and C, respectively. Kaplan–Meier curve analysis with a log-rank test demonstrated that group A had a better progression free survival (PFS) than that of group B (p < 0.0001), and there was no statistical difference in PFS between groups B and C (p = 0.748). Furthermore, group A had a better overall survival than that of group B (p = 0.001), and there was no statistical difference in OS between groups B and C (p = 0.766). In multivariate analyses for PFS in groups A and B, peritoneal cytology, along with lymph-vascular space invasion, were significant poor prognosis factors. Conclusions: Our results suggest that positive peritoneal cytology is a poor prognosis factor in laparoscopic surgery for early-stage endometrial cancer.

Endometrial cancer; Peritoneal cytology; Prognostic factor; Laparoscopic surgery

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