Faculty Collaboration Database

Hysteroscopy and cytology in endometrial cancer. Obstet Gynecol 2004 Nov;104(5 Pt 1):1030-3

Date

11/02/2004

Pubmed ID

15516397

DOI

10.1097/01.AOG.0000143263.19732.18

Scopus ID

2-s2.0-16244364003 (requires institutional sign-in at Scopus site)   51 Citations

Abstract

OBJECTIVE: To estimate the effect of preoperative diagnostic hysteroscopy on peritoneal cytology in patients with endometrial cancer.

METHODS: A total of 256 charts were reviewed. Two cohorts were established based on diagnosis by hysteroscopy or blind endometrial sampling via either endometrial biopsy or dilatation and curettage (D&C). Malignant or suspicious peritoneal cytology was the primary outcome. Cohorts were compared using logistic regression to correct for potential confounders of stage and grade.

RESULTS: A total of 204 cases were diagnosed by endometrial biopsy or D&C, whereas 52 were identified by hysteroscopy. In the endometrial biopsy or D&C arm, 14 of 204 (6.9%) patients had malignant or suspicious cytology compared with 7 of 52 (13.5%) patients in the hysteroscopy arm (P = .15). After logistic regression controlling for stage and grade, the odds ratio for positive cytology after hysteroscopy was 3.88 (95% confidence interval 1.11,13.6; P = .03). Four of the 52 (7.7%) cases diagnosed by hysteroscopy were stage IIIA due to cytology alone compared with 3 of the 204 (1.4%) cases diagnosed by endometrial biopsy or D&C (P = .03).

CONCLUSION: Hysteroscopy appears to be associated with an increased rate of malignant cytology after controlling for confounders of stage and grade. Further, there appears to be an association between hysteroscopy and upstaging patients due to cytology alone.

LEVEL OF EVIDENCE: II-2.

Author List

Bradley WH, Boente MP, Brooker D, Argenta PA, Downs LS, Judson PL, Carson LF

Author

William H. Bradley MD Professor in the Obstetrics and Gynecology department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Biopsy
Dilatation and Curettage
Endometrial Neoplasms
Female
Humans
Hysteroscopy
Logistic Models
Middle Aged
Odds Ratio
Prognosis