The Impact of Cervical Pap Smear on The Prognostic Risk Groups of Endometrial Carcinoma
Abstract views: 217
/ 
PDF downloads: 219
DOI:
https://doi.org/10.58600/eurjther1705Keywords:
Endometrial cancer, prognostic risk, cervical cytology, FIGO stage, adjuvant therapyAbstract
Objective: To investigate the importance of preoperative cervical Pap smear in patients with endometrial cancer and the impact of it on the prognostic risk groups of endometrial cancer.
Methods: The preoperative cervical cytology results of 423 patients who underwent staging surgery for endometrial cancer between the years of 2010 and 2020 in the gynecological oncology clinic of the tertiary center were examined in a retrospective observational study. The relations between cervical Pap smear results and pathological prognostic factors of endometrial cancer such as tumor histology, tumor size, FIGO grade, lymphovascular space invasion and FIGO stage were evaluated in detail. The impact of cervical cytology results in the prognostic risk groups (molecular classification unknown) specified in the ESGO/ESTRO/ESP (2020) guideline was also examined. SPSS version 25.0 program was used in the analysis of the data.
Results: Abnormal cervical Pap cytology was present in 12.1% (n= 51) of the patients included in the study. Significantly more abnormal cervical cytology was observed in the high prognostic risk groups (p= 0.017), tumors with non-endometrioid histologic types (p= 0.001), and patients with adnexal involvement (p= 0.007). In the subgroup analysis of endometrioid type endometrial adenocarcinomas, as the FIGO grade increased, the rate of abnormal cervical cytology increased significantly (p= 0.014).
Conclusions: Pre-operative cervical cytology abnormality may predict the need for intra-operative systematic surgical staging and postoperative adjuvant therapy.
Metrics
References
Bosch FX, Robles C, Díaz M, Arbyn M, Baussano I, Clavel C, et al. (2016) HPV-FASTER: broadening the scope for prevention of HPV-related cancer. Nat Rev Clin Oncol. 13(2):119-132. https://doi.org/10.1038/nrclinonc.2015.146
Frias-Gomez J, Benavente Y, Ponce J, Brunet J, Ibáñez R, Peremiquel-Trillas P, et al. (2020) Sensitivity of cervico-vaginal cytology in endometrial carcinoma: A systematic review and meta-analysis. Cancer Cytopathol. 128(11):792-802. https://doi.org/10.1002/cncy.22266
Costas L, Frias-Gomez J, Guardiola M, Benavente Y, Pineda M, Pavón MÁ, et al. (2019) New perspectives on screening and early detection of endometrial cancer. Int J Cancer. 145(12):3194-3206. https://doi.org/10.1002/ijc.32514
Concin N, Matias-Guiu X, Vergote I, Cibula D, Mirza MR, Marnitz S, et al. (2021) ESGO/ESTRO/ESP guidelines for the management of patients with endometrial carcinoma. Int J Gynecol Cancer. 31(1):12-39. https://doi.org/10.1136/ijgc-2020-002230
Nayar R, Wilbur DC (2015) The Pap test and Bethesda 2014. Cancer Cytopathol. 123(5):271-281. https://doi.org/10.1002/cncy.21521
Siegel RL, Miller KD, Jemal A (2018) Cancer statistics, 2018. CA Cancer J Clin. 68(1):7-30. https://doi.org/10.3322/caac.21442
Aalders JG, Thomas G (2007) Endometrial cancer—revisiting the importance of pelvic and paraaortic lymph nodes. Gynecol Oncol. 104(1):222-231. https://doi.org/10.1016/j.ygyno.2006.10.013
Francis JA, Weir MM, Ettler HC, Qiu F, Kwon JS (2009) Should preoperative pathology be used to select patients for surgical staging in endometrial cancer? Int J Gynecol Cancer. 19(3):380-384. https://doi.org/10.1111/IGC.0b013e3181a1a657
Roelofsen T, Geels YP, Pijnenborg JM, van Ham MA, Zomer SF, van Tilburg JM, et al. (2013) Cervical cytology in serous and endometrioid endometrial cancer. Int J Gynecol Pathol. 32(4):390-398. https://doi.org/10.1097/PGP.0b013e31826a62bb
Skaznik-Wikiel ME, Ueda SM, Frasure HE, Rose PG, Fleury A, Grumbine FC, et al. (2011) Abnormal cervical cytology in the diagnosis of uterine papillary serous carcinoma: earlier detection of a poor prognostic cancer subtype? Acta Cytol. 55(3):255-260. https://doi.org/10.1159/000324052
Khumthong K, Aue-Aungkul A, Kleebkaow P, Chumworathayi B, Temtanakitpaisan A, Nhokaew W (2019) Association of Abnormal Pap Smear with Occult Cervical Stromal Invasion in Patients with Endometrial Cancer. Asian Pac J Cancer Prev. 20(9):2847-2850. https://doi.org/10.31557/APJCP.2019.20.9.2847
Mehta SP, Patel TS, Jana T, Samanta ST, Malvania R, Trivedi PP, et al. (2021) How useful are cervical Pap smears in detecting endometrial carcinomas? A tertiary cancer center experience. Diagn Cytopathol. 49(1):127-131. https://doi.org/10.1002/dc.24609
Gu M, Shi W, Barakat RR, Thaler HT, Saigo PE (2001) Pap smears in women with endometrial carcinoma. Acta Cytol. 45(4):555-560. https://doi.org/10.1159/000327864
DuBeshter B, Warshal DP, Angel C, Dvoretsky PM, Lin JY, Raubertas RF (1991) Endometrial carcinoma: the relevance of cervical cytology. Obstet Gynecol. 77(3):458-462.
Larson DM, Johnson KK, Reyes CN Jr, Broste SK (1994) Prognostic significance of malignant cervical cytology in patients with endometrial cancer. Obstet Gynecol. 84(3):399-403.
Fukuda K, Mori M, Uchiyama M, Iwai K, Iwasaka T, Sugimori H, et al. (1999) Preoperative cervical cytology in endometrial carcinoma and its clinicopathologic relevance. Gynecol Oncol. 72(3):273-277. https://doi.org/10.1006/gyno.1998.5244
Abu-Zaid A, Alsabban M, Alomar O, Abuzaid M, Jamjoom MZ, Salem H, et al. (2020) Preoperative cervical cytology as a prognostic factor in endometrioid-type endometrial cancer: A single-center experience from Saudi Arabia. Avicenna J Med. 10(3):111-117. https://doi.org/10.4103/ajm.ajm_147_19
WHO Classification of Tumours Editorial Board (2020) WHO Classification of Tumours: Female Genital Tumours, 5th edition, volume 4, 2020.
Downloads
Published
How to Cite
License
Copyright (c) 2023 European Journal of Therapeutics
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
The content of this journal is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
