Impact of hysteroscopy on disease-free survival in clinically stage I endometrial cancer patients

Recent data strongly suggest tumor cell dissemination of endometrial carcin oma cells in the course of fluid hysteroscopy. In patients who had endometr ial cancer which was (except for peritoneal cytology) confined to the uteru s, the disease free survival (DFS) of 135 patients who underwent hysterosco py prior to staging laparotomy was compared with the DFS of 127 patients wi thout hysteroscopy. After a median follow-up of 23 months, 10 patients expe rienced tumor recurrence. Although there was a trend towards a higher incid ence of positive peritoneal cytology at laparotomy in patients who underwen t hysteroscopy, this difference did not achieve statistical significance (P = 0.47). For 5 years, the DFS was 92.4% in patients with hysteroscopy and 84.7% in patients without hysteroscopy before laparotomy (log-rank, P = 0.7 82). Our data therefore suggest a similar short-term DFS in endometrial can cer patients with and without hysteroscopy prior to laparotomy.