KEY TAKEAWAYS
- The study aimed to accumulate current evidence on the impact of positive peritoneal cytology.
- The results suggested positive peritoneal cytology negatively impacts survival outcomes in people with endometrial cancer, warranting further research for future staging systems.
For years, positive peritoneal cytology’s impact on early-stage endometrial cancer has stirred controversy. Current staging systems overlook it, but emerging evidence suggests it may affect patient survival.
Vasilios Pergialiotis and the team conducted a systematic review and analysis aiming to gather current evidence.
Researchers conducted searches for relevant articles in databases including Medline, Scopus, the Cochrane Central Register of Controlled Trials CENTRAL, Google Scholar, and Clinicaltrials.gov. Effect sizes were calculated using the meta function in Rstudio. A sensitivity analysis was performed to assess the potential for small-study effects and p-hacking. The trial sequential analysis evaluated the sample size adequacy. The methodological quality of the included studies was assessed using the Newcastle-Ottawa scale.
The present systematic review included 15 articles involving 19,255 women with early-stage endometrial cancer. According to the Newcastle-Ottawa scale, most studies had a moderate risk of bias in participant selection, comparability of groups (positive peritoneal cytology vs. negative peritoneal cytology), and low risk of bias in outcome assessment. Meta-analysis results showed that women with early-stage endometrial cancer and positive peritoneal cytology experienced significantly lower 5-year recurrence-free survival (HR 0.26, 95% CI [0.09, 0.71]).
Consequently, patients with positive peritoneal cytology had reduced 5-year overall survival outcomes (HR 0.50, 95% CI [0.27, 0.92]) due to decreased recurrence-free survival. Conversely, overall survival was notably higher in patients without positive peritoneal cytology (HR 12.76, 95% CI [2.78, 58.51]).
The conclusion suggested that positive peritoneal cytology negatively impacts survival outcomes in patients with endometrial cancer. Given the lack of molecular profile data, further research is necessary to determine its inclusion in future staging systems.
No funding was provided.
Source: https://pubmed.ncbi.nlm.nih.gov/38792916/
Pergialiotis V, Panagiotopoulos M, Koutras A, et al. (2024). “The Impact of Positive Peritoneal Cytology on the Survival Rates of Early-Stage-Disease Endometrial Cancer Patients: Systematic Review and Meta-Analysis.” Medicina (Kaunas). 2024 Apr 28;60(5):733. doi: 10.3390/medicina60050733. PMID: 38792916; PMCID: PMC11123332.
