Is Adjuvant Therapy Necessary For Peritoneal Cytology Positive, Clinical Stage I Endometrial Cancer?: A Prospective, Case Control, Clinical Study

We have designed this study to compare clinical and laboratory findings between peritoneal cytology positive and negative clinical stage I endometrial cancer cases. We performed surgical staging (Total abdominal hysterectomy, Bilateral Salpingooopherectomy, omentectomy, appendectomy, pelvic and paraaortic lymphadenect- omy) according to our clinical protocol for these patients. Peritoneal washing performed to all patients proceeding laparotomy. Six cytology positive patients has been used as study group and twelve cytology negative patients as control group, in totally 120 stage I endometrial cancer cases between 1993-1998. The demographic parameters of two groups were resembling to each other. No adjuvant therapy was used. The follow-up protocol was; pelvic examination, vaginal cytology, serum Ca-125 levels, routine blood tests by two months intervals, for two years, by six months interval for third year and abdominopelvic CT was planned annually. The results were analysed by chi square test. There was no statistically significant differences between two groups at the end of three years follow-up. There was no recurrences in two groups. Peritoneal positivity can arise from transtubal spreading of tumor cells during probe curettage avoked uterine contractions or false positive cytologic examination. So we do not recommend adjuvant therapy for cytology positive patients when the tumor is limited to uterus, to avoid the morbidity of the adjuvant therapy.