Does duration of hysteroscopy increase the risk of disease recurrence in patients with endometrial cancer? A multi-centre trial

Tempfer,Clemens  B.; Froese,Georg; Buerkle,Bernd; Polterauer,Stephan; Grimm,Christoph; Concin,Nicole; Hofstetter,Gerda; Weigert,Monika; Oehler,Martin  K.

doi:10.3892/etm.2011.309

September-October 2011 Volume 2 Issue 5

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September-October 2011 Volume 2 Issue 5

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Article

Does duration of hysteroscopy increase the risk of disease recurrence in patients with endometrial cancer? A multi-centre trial

Authors:
- Clemens B. Tempfer
- Georg Froese
- Bernd Buerkle
- Stephan Polterauer
- Christoph Grimm
- Nicole Concin
- Gerda Hofstetter
- Monika Weigert
- Martin K. Oehler
View Affiliations / Copyright

Affiliations: Department of Obstetrics and Gynaecology, Ruhr University Bochum, D-44625 Herne, Germany, Department of Surgery, St. Elisabeth Hospital, Vienna, Austria, Department of Obstetrics and Gynaecology, Ruhr University Bochum, D-44625 Herne, Germany, Department of Obstetrics and Gynecology, Medical University of Vienna, Vienna, Austria, Department of Obstetrics and Gynecology, Medical University of Vienna, Vienna, Austria, Department of Obstetrics and Gynecology, Medical University of Innsbruck, Innsbruck, Austria, Department of Obstetrics and Gynecology, Medical University of Innsbruck, Innsbruck, Austria, Department of Obstetrics and Gynecology, Landesklinikum Wiener Neustadt, Wiener Neustadt, Austria, Department of Gynecologic Oncology, Royal Adelaide Hospital, Adelaide, Australia
Pages: 991-995
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Published online on: June 30, 2011

https://doi.org/10.3892/etm.2011.309
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Abstract

Women with endometrial cancer often undergo hysteroscopy during their diagnostic work-up. Whether or not the duration of hysteroscopy affects the rate of positive peritoneal cells and the duration of recurrence-free survival is unknown. In a retrospective multi-centre study, the records of 552 patients with endometrial cancer were investigated. Duration of hysteroscopy was correlated with clinicopathological parameters and patient survival data. The mean [standard deviation (SD)] duration of hysteroscopy was 18.2 (10.5) min in the study population and 17.9 (10.1) min and 17.9 (10.2) min in patients with positive (n=109) and negative peritoneal cytology (n=443), respectively (p=0.9). There were no statistically significant correlations between duration of hysteroscopy and positive peritoneal cytology (p=0.6; rho=-0.028), FIGO stage (p=0.2; rho=-0.080), lymph node involvement (p=0.2; rho=0.106) and patient age (p=0.5; rho=0.033). Longer duration of hysteroscopy (>15 min) was not associated with positive peritoneal cytology (yes vs. no, p=0.8), advanced tumour stage (FIGO I vs. II, III and IV, p=0.3), lymph node involvement (yes vs. no, p=0.1) and patient age (≤65 vs. >65 years, p=0.4). In a multivariate analysis, FIGO stage [p<0.0001; hazard ratio (HR)=5.1, 95% confidence interval (CI) 2.5-10.2], lymph node involvement (p=0.02; HR=3.2, 95% CI 1.2-8.8) and patient age (p=0.003; HR=2.4, 95% CI 1.3-4.2), but not duration of hysteroscopy (p=0.4; HR=1.2, 95% CI 0.7-2.2), were associated with recurrence-free survival. We conclude that longer duration of hysteroscopy does not increase the risk of positive peritoneal cytology and it is not an adverse prognostic factor for recurrence-free survival in patients with endometrial cancer.

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1.	Parkin DM, Whelan SL, Ferlay J, Teppo L and Thomas DB: Cancer Incidence in Five Continents. VIII. IARC Press; Lyon: 2002
2.	Creasman WT, Odicino F, Maisonneuve P, Beller U, Benedet JL, Heintz AP, Ngan HY, Sideri M and Pecorelli S: Carcinoma of the corpus uteri. J Epid Biostat. 6:47–86. 2001.PubMed/NCBI
3.	Coulter A, Kelland A and Long A: The management of menorrhagia. Effective Health Care Bull. 9:1–14. 1995.
4.	Spencer CP and Whitehead MI: Endometrial assessment revisited. Br J Obstet Gynaecol. 106:623–632. 1999. View Article : Google Scholar : PubMed/NCBI
5.	Mencaglia L: Hysteroscopy and adenocarcinoma. Obstet Gynecol Clin North Am. 22:573–579. 1995.PubMed/NCBI
6.	Clark TJ, Voit D, Gupta JK, Hyde C, Song F and Khan KS: Accuracy of hysteroscopy in the diagnosis of endometrial cancer and hyperplasia: a systemic quantitative review. JAMA. 288:1610–1621. 2002. View Article : Google Scholar : PubMed/NCBI
7.	Nagele F, Wieser F, Deery A, Hart R and Magos A: Endometrial cell dissemination at diagnostic hysteroscopy: a prospective randomized cross-over comparison of normal saline and carbon dioxide uterine distension. Hum Reprod. 14:2739–2742. 1999. View Article : Google Scholar
8.	Obermair A, Geramou M and Gucer F: Does hysteroscopy facilitate tumor cell dissemination? Incidence of peritoneal cytology from patients with early stage endometrial carcinoma following dilatation and curettage versus hysteroscopy and dilatation and curettage. Cancer. 88:139–143. 2000.
9.	Polyzos NP, Mauri D, Tsioras S, Messini CI, Valachis A and Messinis IE: Intraperitoneal dissemination of endometrial cancer cells after hysteroscopy: a systematic review and meta-analysis. Int J Gynecol Cancer. 20:261–267. 2010. View Article : Google Scholar : PubMed/NCBI
10.	Obermair A, Geramou M, Tripcony L, Nicklin JL, Perrin L and Crandon AJ: Peritoneal cytology: impact on disease-free survival in clinical stage I endometrioid adenocarcinoma of the uterus. Cancer Lett. 164:105–110. 2001. View Article : Google Scholar : PubMed/NCBI
11.	Selvaggi L, Cormio G, Ceci O, Loverro G, Cazzolla A and Bettocchi S: Hysteroscopy does not increase the risk of microscopic extrauterine spread in endometrial carcinoma. Int J Gynecol Cancer. 13:223–227. 2003. View Article : Google Scholar : PubMed/NCBI
12.	Cicinelli E, Tinelli R, Colafiglio G, Fortunato F, Fusco A, Mastrolia S, Fucci AR and Lepera A: Risk of long-term pelvic recurrences after fluid minihysteroscopy in women with endome-trial carcinoma: a controlled randomized study. Menopause. 17:511–515. 2010.PubMed/NCBI
13.	Ben-Arie A, Tamir S, Dubnik S, Gemer O, Ben Shushan A, Dgani R, Peer G, Barnett-Griness O and Lavie O: Does hysteroscopy affect prognosis in apparent early-stage endometrial cancer? Int J Gynecol Cancer. 18:813–819. 2008. View Article : Google Scholar : PubMed/NCBI
14.	Serden SP: Diagnostic hysteroscopy to evaluate the cause of abnormal uterine bleeding. Obstet Gynecol Clin North Am. 27:277–286. 2000. View Article : Google Scholar : PubMed/NCBI
15.	O’Rogerson L and Duffy S: A national survey of outpatient hysteroscopy. Gynecol Endosc. 10:343–348. 2001.
16.	Nag S, Erickson B, Parikh S, Gupta N, Varia M and Glasgow G: The American Brachytherapy Society recommendations for high-dose-rate brachytherapy for carcinoma of the endometrium. Int J Radiat Oncol Biol Phys. 48:779–790. 2000. View Article : Google Scholar : PubMed/NCBI

Journals

International Journal of Molecular Medicine

International Journal of Oncology

Molecular Medicine Reports

Oncology Reports

Experimental and Therapeutic Medicine

Oncology Letters

Biomedical Reports

Molecular and Clinical Oncology

World Academy of Sciences Journal

International Journal of Functional Nutrition

International Journal of Epigenetics

Medicine International

Does duration of hysteroscopy increase the risk of disease recurrence in patients with endometrial cancer? A multi-centre trial

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