Significance of peritoneal washing cytology in the accurate staging of malignant ovarian tumors.

Rubina Gulzar,Jahan Ara Hasan,Ruqaiya Shahid,Shazia Mumtaz

doi:10.12669/pjms.38.1.4393

Rubina Gulzar, Jahan Ara Hasan + Show 2 more

Open Access

https://doi.org/10.12669/pjms.38.1.4393

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Abstract

ABSTRACTObjectives:To identify the percentage of ovarian cancers with positive peritoneal cytology and to correlate the positive cytology with the prognostic factors.Methods:This retrospective, cross-sectional study, evaluated the data of surgical specimens of malignant ovarian tumors, received in the Department of Pathology, Dow University of Health Sciences over a period of three years. The peritoneal cytology was correlated with these prognostic parameters: the size of the tumor, stage, capsular invasion, omental, and lymph node metastasis.Results:Eighty malignant ovarian tumors were diagnosed. Serous carcinoma was the most common ovarian tumor, diagnosed in 24(30.0%) cases, followed by endometrioid carcinoma in 17(21.25%) and Granulosa cell tumor in 11 (13.75%) cases. The mean age of the patients was 41.91 years (range 7-71 years). The mean size of the tumors was 10.03 cm (SD 5.62 cm). The ovarian capsular invasion was present in 27(33.75%) tumors. Peritoneal cytology was positive in 10/24 cases, with a detection rate of 41.66%. Omentum was involved in 12/34(35.29%) cases. Lymph node dissection was performed in three cases, two were reported as positive for metastasis. Peritoneal cytology significantly correlated with the tumor size (p=0.045), and with ovarian capsular invasion (p=0.054) and omental metastasis (p=0.052). Most of the tumors were staged as FIGO stage IA.Conclusion:Peritoneal cytology correlates with the tumor size, stage, and omental metastasis of the malignant ovarian tumors. It should be routinely performed at the time of surgery for the optimal staging of the patients.

Highlights

Ovarian cancer is one of the leading causes of motility and morbidity throughout the world.[1]
Ovarian cancer has an age-standardized incidence rate (ASR) of 7/100,000 and a mortality rate of 3.8/100,000 females in the world, according to Globocan 2018.1 In Pakistan ovarian cancer is the seventh common cancer in Pakistan, with an ASR of 3.3/100,000 female population, which is lower than the neighboring countries like Turkey (6.3), Afghanistan (3.8), China (4.1), and India (4.9).[2]
Tumor histopathological classification was according to the World Health Organization (WHO) and staging was according to the Federation of Gynecology and Obstetrics (FIGO) protocols.[4,7]

Summary

Introduction

Ovarian cancer is one of the leading causes of motility and morbidity throughout the world.[1]. The staging of ovarian tumors depends upon the capsular invasion and on the trans-coelomic spread of the disease.[1] Peritoneal washing is taken at the time of surgery, and the fluid is evaluated for the presence of malignant cells.[4,5] Positive peritoneal cytology is associated with morbidity and tumor recurrence.[4] According to the revised staging by the International Federation of Gynecology and Obstetrics (FIGO), positive peritoneal cytology upstages the ovarian cancer from IA to IC, which requires chemotherapy after the surgery.[4,6] The absence of peritoneal cytology with the surgical specimen results in an incomplete staging of the ovarian cancers. This study was conducted to highlight the importance of peritoneal cytology in the accurate staging of malignant ovarian tumors. The objective of this study was to identify the percentage of ovarian cancers with positive peritoneal cytology and to correlate the positive cytology with the prognostic factors

Objectives

Methods

Results

Conclusion