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Conversion of intraperitoneal cytology during laparoscopic surgery of uterine cancer

  • Gynecologic Oncology
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Introduction

The laparoscopic surgery of uterine cancer is an oncological safe treatment option in early stage cancer. However, there are no data about whether laparoscopy can lead to intraperitoneal tumor cell dissemination. We aimed in our study to detect a possible cytological conversion during laparoscopic procedures.

Methods

In this prospective study, we included all patients receiving laparoscopic treatment at the early stage endometrial and cervical cancer in the Department of Obstetrics and Gynecology at the University of the Saarland and obtained peritoneal wash for cytological examination at the beginning and at the end of laparoscopic surgery. All patients received stage-adjusted operative and adjuvant therapy.

Results

We enrolled 43 patients [endometrial cancer (n = 24) and cervical cancer (n = 19)]. At the beginning of the operation, one patient with endometrial cancer and one patient with cervical cancer showed a positive cytology. One tumor cell conversion from negative to positive cytology during surgery was detected in a patient suffering from endometrial cancer stage FIGO Ia. The median duration of surgery was 191.8 ± 79.3 min. The average time of follow-up was 16.5 ± 10.3 month. At the end of data evaluation at December 2014, two patients (8.6 %) are suffering from recurrent disease, two patients died, none of these patients had a positive cytology. All patients with positive cytology are free of cancer.

Conclusion

During laparoscopic surgery of early stage endometrial and cervical cancer, only one conversion of cytology was detected, which proves that laparoscopy does not appear to increase the intraoperative tumor cell dissemination or rate of positive cytological results.

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Authors and Affiliations

  1. Department of Obstetrics and Gynecology, University of Saarland, Kirrbergerstr. 100, 66424, Homburg/Saar, Germany

    A. von Heesen, Z. Takacs, L. Gabriel, A. Hamza, G. Meyberg-Solomayer, E. -F. Solomayer & I. Juhasz-Böss

  2. Department of Otorhinolaryngology, Head and Neck Surgery, University of Saarland, Kirrbergerstr. 100, 66424, Homburg/Saar, Germany

    M. Linxweiler

  3. Department of Surgery, University of Saarland, Kirrbergerstr. 100, 66424, Homburg/Saar, Germany

    M. von Heesen

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  1. A. von Heesen
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  3. L. Gabriel
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Correspondence to A. von Heesen.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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von Heesen, A., Takacs, Z., Gabriel, L. et al. Conversion of intraperitoneal cytology during laparoscopic surgery of uterine cancer. Arch Gynecol Obstet 294, 847–854 (2016). https://doi.org/10.1007/s00404-016-4102-1

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