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. 2017 Jul-Sep;6(3):113-115.
doi: 10.1016/j.gmit.2016.10.002. Epub 2016 Dec 31.

Risk of spilling cancer cells during total laparoscopic hysterectomy in low-risk endometrial cancer

Satoshi Shinohara  1 , Ikuko Sakamoto  1 , Masahiro Numata  1 , Atsushi Ikegami  1 , Katsuhiro Teramoto  1
Affiliations

Risk of spilling cancer cells during total laparoscopic hysterectomy in low-risk endometrial cancer

Satoshi Shinohara et al. Gynecol Minim Invasive Ther. 2017 Jul-Sep.

Abstract

Objective: To evaluate the risk of spilling cancer cells during total laparoscopic hysterectomy (TLH) using a uterine manipulator in early-stage endometrial cancer patients.

Materials and methods: We conducted a prospective study among women undergoing TLH for Clinical Stage IA endometrial cancer between March 2015 and November 2015. Peritoneal washings before the insertion of the uterine manipulator and after TLH were obtained. The two sets of washings were reviewed by a cytopathologist to determine the presence or absence of malignant cells in a blinded manner.

Results: Thirteen endometrial cancer patients (age 39-79 years, median: 62.2 years) were enrolled. The postoperative tumor grades were: G1: 11 (84.6%) and G2: 2 (15.4%). All patients underwent TLH and bilateral salpingo-oophorectomy. Pelvic/para-aortic lymph node dissection was not performed in all cases. Only one patient showed positive peritoneal cytology in the pre-TLH sample. There was high agreement (92.3%) between the two sets of washings in all patients. No patients received postoperative treatment.

Conclusion: We conclude that fallopian tubal cauterization is sufficient to provide protection from the dissemination of cancer cells into the peritoneal cavity at the time of TLH for endometrial cancers in early stages.

Keywords: dissemination; early stage; endometrial cancer; total laparoscopic hysterectomy.

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Conflict of interest statement

Conflicts of Interest: The authors declare no conflicts of interest pertaining to this study.

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References

    1. Yamagami W, Aoki D. Annual report of the Committee on Gynecologic Oncology, the Japan Society of Obstetrics and Gynecology. J Obstet Gynaecol Res. 2015;41:1861–1869. - PubMed
    1. Lim S, Kim HS, Lee KB, Yoo CW, Park SY, Seo SS. Does the use of a uterine manipulator with an intrauterine balloon in total laparoscopic hysterectomy facilitate tumor cell spillage into the peritoneal cavity in patients with endometrial cancer? Int J Gynecol Cancer. 2008;18:1145–1149. - PubMed
    1. Terao Y, Kitade M, Kusunoki S, et al. Surgical and oncological outcome of laparoscopic surgery, compared to laparotomy, for Japanese patients with endometrial cancer. Gynecol Minim Invasive Ther. 2016;5:64–68.
    1. Krizova A, Clarke BA, Bernardini MQ, et al. Histologic artifacts in abdominal, vaginal, laparoscopic, and robotic hysterectomy specimens: a blinded, retrospective review. Am J Surg Pathol. 2011;35:115–126. - PubMed
    1. Eltabbakh GH, Mount SL. Laparoscopic surgery does not increase the positive peritoneal cytology among women with endometrial carcinoma. Gynecol Oncol. 2006;100:361–364. - PubMed

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