Geburtshilfe Frauenheilkd 2016; 76 - P050
DOI: 10.1055/s-0036-1592693

Detection of microscopic peritoneal spread in gynecological cancers using diaphragmatic scrapings adds no benefit to standard staging procedures

U Mirza 1, C Montavon 1, A Schötzau 2, R Zanetti 1, V Heinzelmann-Schwarz 1, 2
  • 1University Hospital Basel, University of Basel, Department of Gynecology and Gynecological Oncology, Hospital for Women, Basel, Schweiz
  • 2Ovarian Cancer Research Group, Department of Biomedicine, University Hospital Basel, University of Basel, Basel, Schweiz

Introduction: Cytological diaphragmatic smears (DS), are not routinely taken in abdominal staging of gynecological malignancies. There is hardly any data comparing this technique to other routine measures. The aim of this study was to evaluate the additional diagnostic benefit of DS compared to peritoneal washing (PW) and peritoneal biopsies (PB).

Material and Methods: We retrospectively studied 43 patients where a laparotomy for suspected gynecological cancer was performed and DS taken. The DS samples were obtained always by the same surgeon using a cervical cytobrush.

Results: 41 carcinomas were analyzed. Of those, only one case was positive in an early stage, 2 were positive in an advanced stage. In the whole cohort, we found 18 positive cases of PW (46.2%) and 19 cases of positive PB (48.7%). In 7 of 40 cases DS was negativ when the corresponding PW was positive (17.5%). In 10 of 39 cases, DS and PB did not correlate (25.6%), 1 case being positive in DS and negativ in PB, and 9 cases vice versa. The positive DS, however, had correlating positive PW. DS were positive in 11 of 41 (28.2%) malignant cases, independent of the side taken.

Conclusion: None of our cases discovered peritoneal disease or was upstaged solely based upon positive diaphragmatic smear. Hence, this technique is of no benefit additionally to peritoneal washings and peritoneal biopsies.