The Contribution of Rapid Intraoperative Cytology to the Improvement of Ovarian Cancer Staging

• Published in: Gynecologic oncology 2002-09, Vol.86 (3), p.244-249
• Main Authors: Anastasiadis, P.G., Romanidis, K.N., Polichronidis, A., Koutlaki, N.G., Tamiolakis, D., Simopoulos, K.
• Format: Article
• Language: English
• Subjects: Biological and medical sciences; Biopsy; Cytological Techniques - methods; Female; Female genital diseases; Gynecology. Andrology. Obstetrics; Humans; imprint cytology; Intraoperative Period; lymph node biopsy; Lymph Nodes - pathology; Medical sciences; Neoplasm Staging - methods; ovarian cancer staging; Ovarian Neoplasms - pathology; Ovarian Neoplasms - surgery; Peritoneal Cavity - pathology; peritoneal washing cytology; Tumors
• ISSN: 0090-8258; 1095-6859
• DOI: 10.1006/gyno.2002.6626

Objective. The goal of this work was to evaluate the use of intraoperative cytology in the improvement of ovarian cancer staging. Methods. Fifty-two patients with clinical stage IA–IIB ovarian cancer underwent peritoneal washing (PW) cytology and imprint cytology performed on retroperitoneal lymph node samples, during primary surgical treatment. Cytologic specimens were stained by the May–Grünwald–Giemsa (MGG) and hematoxylin–eosin (HE) techniques. Pertinent histologic sections of the ovarian lesions, cell blocks prepared from PW sediments, and lymph node samples were studied and compared with the cytologic findings. Results. Our study reveals that, when malignant cells are present in the peritoneal cavity, PW cytology has 84.6% sensitivity and 94.7% specificity in detecting them. Imprint cytology performed on lymph node samples presented 94.1% sensitivity and 94.1% specificity in the diagnosis of retroperitoneal metastasis of ovarian cancer. Only 7 patients (13.4%) were upstaged with either cytologic method. PW cytology alone upstaged 6 more patients, while imprint cytology alone upstaged 11 more patients. This corresponds to a total of 17 patients (32.6%) who benefit from the combined performance of both cytologic methods. HE stain presents lower values of sensitivity and specificity compared with MGG. Conclusion. Cytologic evaluation of intraperitoneal and retroperitoneal spread of ovarian cancer by use of PW cytology and imprint cytology performed on lymph node samples contributes to the improvement of ovarian cancer staging.