The significance of rapid intraoperative cytology in the evaluation of intraperitoneal and retroperitoneal spread of cervical cancer.

OBJECTIVE

To evaluate the contribution of the rapid intraoperative cytology (peritoneal washing [PW] cytology together with imprint cytology performed on lymph node samples) in the assessment of peritoneal and retroperitoneal dissemination of cervical cancer.

METHODS

Seventy-nine patients with clinical Stage IA2-IIA cervical cancer underwent PW cytology and imprint cytology performed on retroperitoneal lymph node samples during primary surgical treatment. Cytologic specimens were stained with the May-Grünwald-Giemsa (MGG) and hematoxylin-eosin (HE) techniques. Pertinent histologic sections of the cervical lesions, of the cell blocks prepared from PW sediments, and of the lymph node sampling were studied and compared with the cytologic findings.

RESULTS

PW cytology was positive in 2.5% of the patients, and lymph node imprints revealed metastases in 19% of the patients. Cervical adenocarcinomas presented increased rates of metastatic disease in both the peritoneal cavity and retroperitoneum. HE presented higher sensitivity in detecting malignant cells in the peritoneal fluids, while MGG gave more accurate results in the diagnosis of lymph node metastases.

CONCLUSIONS

Cytologic evaluation of intraperitoneal and retroperitoneal spread of cervical cancer by use of PW cytology and imprint cytology performed on lymph node samples contributes to the assessment of the extent of disease and therefore could be useful in further treatment of the patient.