The assessment of residual ovarian cancer by cytological examination of peritoneal washings obtained by culdocentesis

Abstract

Peritoneal washings were obtained from 64 patients with histologically proven ovarian cancer in a prospective study of cytological abnormalities in these fluid samples. Of 91 attempts at culdocentesis, no fluid was obtained in 15 (16%). Two cell types were identifiable in the fluid: mesothelial cells and carcinoma cells. On the basis of our follow-up, the information from the cytological examination reflected accurately the tumor status in 62 of 69 samples—an accuracy rate of 90%. These findings support the use of this test in the assessment of residual ovarian cancer; in particular, a report of carcinoma cells in the fluid would indicate presence of subclinical disease, and the need for continuation of chemotherapy. However, a false negative report may be obtained in the presence of pelvic adhesions which reduce the access to the general peritoneal cavity.