SIGNIFICANCE OF INTRAPERITONEAL CYTOLOGY IN PATIENTS UNDERGOING RADICAL HYSTERECTOMY

The incidence and prognostic significance of positive intraperitoneal cytology taken during a radical hysterectomy was reviewed. A prospecti ve study looking at intraperitoneal cytology was conducted by using 40 0 consecutive radical hysterectomies from January 1988 through June 19 96. All selected patients had peritoneal washings performed prior to a radical hysterectomy with pelvic and para-aortic lymphadenectomy. A s ingle pathologist reviewed all cytological and histologic specimens. A total of 400 patients were included in the study. Only 7 of 400 (1.8% ) had positive intraperitoneal cytology. Four had squamous cell cancer and 3 had adenocarcinoma. Five had stage IB cervical cancer and the r emainder were stage IIA. Three had positive nodes. Six of 7 had tumor size greater than 3 cm. Three of 7 had >50% invasion and 2 of 7 had ly mpho-vascular space invasion. No other risk factors were present in th ese specimens. Six of 7 recurred within 18 months of surgery. Recurren ces were local or retroperitoneal; none were upper abdomen or intraper itoneal. The incidence of positive peritoneal cytology during radical hysterectomy is 1.8%. The cost of these cytology specimens did not off er an advantage to the current surgical-pathological factors used to d etermine prognosis and adjuvant therapy. (C) 1998 Academic Press.