Abstract
This study evaluated the influence of positive peritoneal cytology (PPC) on the prognosis of patients with stage IA endometrial cancer, and the usefulness of adjuvant chemotherapy in their treatment. We retrospectively analyzed the data of patients with stage IA endometrial cancer admitted in our hospital between 2005 and 2015. Among 989 patients who underwent peritoneal cytology, 135 (13.7%) had PPC. Multivariate analysis extracted several independent risk factors for recurrence in stage IA patients, including those with PPC. Adjuvant chemotherapy did not cause a significant difference in the 5-year relapse-free survival rate in patients with PPC (p = 0.78). Similarly, the 5-year recurrence-free survival rate with or without chemotherapy was not different among type II cancer patients (p = 0.11). However, the baseline risk of 5-year relapse-free survival without chemotherapy in patients with PPC and type II was very low (66.7%). While PPC was an independent risk factor for recurrence in stage IA endometrial cancer, adjuvant chemotherapy did not influence the survival rate in patients with PPC. While it is controversial whether adjuvant chemotherapy should be administered in stage IA uterine cancer with only PPC as a prognostic factor, it should be considered for early-stage patients who have multiple risk factors for recurrence.
Highlights
This study evaluated the influence of positive peritoneal cytology (PPC) on the prognosis of patients with stage IA endometrial cancer, and the usefulness of adjuvant chemotherapy in their treatment
Approximately 75 to 80% of endometrial cancer patients are diagnosed at Federation of Gynecology and Obstetrics (FIGO) Stage I, and stage IA patients are known to have a favorable prognosis with a 5-year survival rate ≥ 90%3,4
Studies show that PPC does not influence the prognosis of stage III cancers unlike other factors like lymph node metastasis, and uterine serosal or adnexal metastasis, but it is unclear whether PPC influences the prognosis in patients with early stage endometrial cancer (EEC)[5,6,7]
Summary
This study evaluated the influence of positive peritoneal cytology (PPC) on the prognosis of patients with stage IA endometrial cancer, and the usefulness of adjuvant chemotherapy in their treatment. While PPC was an independent risk factor for recurrence in stage IA endometrial cancer, adjuvant chemotherapy did not influence the survival rate in patients with PPC. Approximately 75 to 80% of endometrial cancer patients are diagnosed at Federation of Gynecology and Obstetrics (FIGO) Stage I, and stage IA patients are known to have a favorable prognosis with a 5-year survival rate ≥ 90%3,4. The objective of this study was to evaluate the influence of potential independent risk factors like PPC on the prognosis of patients with very early stage, stage IA endometrial cancer, and to assess the usefulness of postoperative adjuvant chemotherapy in its treatment
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