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Gazzetta Medica Italiana Archivio per le Scienze Mediche 2013 May;172(5):335-42


language: Italian

Histeroscopy for the diagnosis of endometrial neoplasm: risk factor for neoplastic cell diffusion?

Gallia L. 1, Cunzolo T. 1, Cannì M. 1, Bocci F. 1, Bertini U. 1, Bocci C. 1, Rabino V. 1, Feyles E. 2, Barbero M. 1

1 S.O.C. Ostetricia e Ginecologia ASL AT Asti, Italia; 2 S.O.C. di Anatomia Istologia Patologia e Citodiagnostica ASL AT, Asti, Italia


Aim: Histeroscopy is the tool of choice for the evaluation of the endometrial cavity, including assessment of abnormal uterine bleeding (AUB). The combination of endometrial biopsy and diagnostic hysteroscopy could replace dilatation and curretage in most patients. Our aim was to assess if diagnostic hysteroscopy increases the risk of positive peritoneal washings in patients with endometrial cancer and affects the prognosis after surgery.
Methods: Retrospective cohort study. The medical record of 140 patients with endometrial cancer, diagnosed with fluid hysteroscopy (n=66 cases), dilatation and curettage (D&C), (N.=28 cases), and operational hysteroscopy (n=46 cases, were rewieved. Fluid hysteroscopy was performer by using saline solution irrigated at a final flow of 150 ml/min with a intrauterine pressure ranging between 25 and 50 mmHg. The presence of suspicious or positive peritoneal cytology was considered the endpoint of this analysis.
Results: There were 122 cases (87%) of endometroid adenocarcinoma and 18 cases (13%) of poor hystological types, including clear cell, serous papillary and small cell cancer. Peritoneal cytology was available in only 134 patients and was positive in 6 cases (4.5%): 5 positive cases were observed in patients had stage III disease, and o one had stage I.
Conclusion: No significant difference in the survival-recurrance rate between the different diagnostic methods applied was found. Diagnostic fluid hysteroscopy has not adverse effects on the incidence of microscopic intraperitoneal spread or on prognosis in endometrial cancer patient

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