Peritoneal cytology evaluation at hysterectomy for endometrial cancer: changes in guideline adherence in the United States

Abstract

Objectives: In 2009, the International Federation of Gynecology and Obstetrics revised 30 cancer staging schema for endometrial cancer and removed peritoneal cytology from the staging criteria. This study examined population-based trends, characteristics, and outcomes of peritoneal cytologic sampling for endometrial cancer surgery following the 2009 staging revision in the United States. Methods: This is a retrospective observational study querying the National Cancer Institute's Surveillance, Epidemiology, and End Results Program to examine women with stage I-III endometrial cancer who underwent hysterectomy from 2010-2017. Trends, characteristics, and survival associated with peritoneal cytologic evaluation at the time of hysterectomy were assessed in multivariable analysis and with propensity score weighting. Results: Among 62,809 women who underwent hysterectomy, 43,873 (69.9%) had peritoneal cytologic evaluation at surgery and 18,936 (30.1%) did not. Utilization of peritoneal cytologic evaluation decreased from 75.5% to 64.9% during the study period (P Download : Download high-res image (94KB) Download : Download full-size image Conclusions: Despite guideline recommendations, performance of peritoneal cytologic sampling has gradually decreased following the 2009 staging revision in the United States. Our study suggested that peritoneal cytology evaluation at hysterectomy may be associated with improved survival in endometrial cancer.