[Call for the standardized application of ascites/peritoneal flushing fluid cytology in the diagnosis and treatment of endometrial cancer].

The International Federation of Gynecology and Obstetrics (FIGO) staging system for endometrial cancer (EC) integrates various clinicopathological factors associated with EC prognosis to aid in prognosis prediction and treatment guidance. Although the 2009 FIGO staging criteria excluded ascites/peritoneal flushing fluid cytology, the importance of this factor remains controversial. This review thoroughly analyzed the current problems in ascites/peritoneal flushing fluid cytology sample submission and investigates the association between positive ascites/peritoneal flushing fluid cytology (PAC/PPC) and EC prognosis across different patient groups, including various stages, histological types, risk stratifications, and molecular subtypes. The findings demonstrated that PPC significantly impacted patient prognosis. Therefore, based on current evidence, the author advocates for the continued submission of ascites/peritoneal flushing fluid cytology as a crucial and indispensable step in the surgical staging of EC. In clinical practice, emphasis should be placed on the accuracy, reliability, and submission rate of EC cytology testing. The necessity for more aggressive treatment approaches requires the validation through large-scale prospective studies.