[The impact of peritoneal cytology test results on the prognosis of patients with uterine serous carcinoma].

Objective

To explore the impact of peritoneal cytology (PC) test results on prognosis in patients with uterine serous carcinoma (USC).

Methods

Medical record information including history of tubal ligation and preoperative hysteroscopy, pathology, surgery, adjuvant therapy, etc. of USC patients admitted to the Cancer Hospital, Chinese Academy of Medical Sciences from January 2004 to December 2020 was retrospectively collected and the cytological sections of PC were reviewed. Positive peritoneal cytology (PPC) patients were classified as PPC group while negative peritoneal cytology (NPC) patients were NPC group. The survival analyses were performed by Kaplan Meier method and prognostic factors of USC patients were analyzed by Cox proportional hazards regression model.

Results

A total of 147 USC patients were included, aged [M(Q1,Q3)] 60 (54, 64) years. There were 43 cases (29.3%) in the PPC group and 104 cases (70.7%) in the NPC group. The follow-up time was [M(Q1,Q3)] 60 (34, 73) months, with 52 cases of USC recurrence and 30 patients deaths. The 5-year progression free survival rate was 66.5% and the 5-year overall survival rate was 79.2%. Both 5-year progression free survival rate (41.2% vs 77.0%) and 5-year overall survival rate (58.6% vs 87.1%) were lower in PPC group than those in NPC group (both P<0.001). In 102 patients without pelvic abdominal involvement (stage Ⅰ, Ⅱ, and stage Ⅲ patients with only lymph node metastasis), PPC was associated with USC recurrence (HR=4.191, 95%CI: 1.729-10.165) and USC patients death (HR=4.306, 95%CI: 1.351-13.731). Among 45 patients with pelvic abdominal involvement, PPC was not associated with USC recurrence (HR=1.450, 95%CI: 0.637-3.303) or patient death (HR=1.520, 95%CI: 0.488-4.730).

Conclusions

In USC patients, compared with NPC, PPC patients have poorer prognosis. PPC is a factor for prognosis in USC patients without pelvic abdominal involvement.