Incidence of positive peritoneal cytology in patients with endometrial carcinoma after hysteroscopy vs. dilatation and curettage

Background: The aim of the study was to compare the frequency of positive peritoneal washings in endometrial cancer patients after either hysteroscopy (HSC) or dilatation and curettage (D&C). Patients and methods: We performed a retrospective analysis of 227 patients who underwent either HSC (N = 144) or D&C (N = 83) and were diagnosed with endometrial carcinoma at the University Medical Centre Maribor between January 2008 and December 2014. The incidence of positive peritoneal cytology was evaluated in each group. Results: There was no overall difference in the incidence of positive peritoneal washings after HSC or D&C (HSC = 13.2%D&C = 12.0%p = 0.803). However, a detailed analysis of stage I disease revealed significantly higher rates of positive peritoneal washings in the HSC group (HSC = 12.8%D&C = 3.4%p = 0.046). Among these patients, there was no difference between both groups considering histologic type (chi-square = 0.059p = 0.807), tumour differentiation (chi-square = 3.709p = 0.156), the time between diagnosis and operation (t = 0.930p = 0.357), and myometrial invasion (chi-square = 5.073p = 0.079). Conclusions: Although the diagnostic procedure did not influence the overall incidence of positive peritoneal washings, HSC was associated with a significantly higher rate of positive peritoneal cytology in stage I endometrial carcinoma compared to D&C