Prognostic significance of right subdiaphragmatic washing cytology in patients with endometrial cancer
Abstract Cancer cells in the right subdiaphragmatic lavage may reflect peritoneal dissemination, but its prognostic significance is unknown. This study investigated recurrence-free survival (RFS), overall survival (OS), and recurrence patterns in patients with curatively resected endometrial cancer...
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Nature Portfolio
2025-01-01
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| Series: | Scientific Reports |
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| Online Access: | https://doi.org/10.1038/s41598-025-86784-4 |
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| author | Takanori Yokoyama Shinichi Okame Mika Okazawa-Sakai Etsuko Fujimoto Yumi Hibino Norihiro Teramoto Kazuhiro Takehara |
| author_facet | Takanori Yokoyama Shinichi Okame Mika Okazawa-Sakai Etsuko Fujimoto Yumi Hibino Norihiro Teramoto Kazuhiro Takehara |
| author_sort | Takanori Yokoyama |
| collection | DOAJ |
| description | Abstract Cancer cells in the right subdiaphragmatic lavage may reflect peritoneal dissemination, but its prognostic significance is unknown. This study investigated recurrence-free survival (RFS), overall survival (OS), and recurrence patterns in patients with curatively resected endometrial cancer by cytology collection site. Peritoneal cytology was collected at the beginning of surgery by washing the pelvic and right subdiaphragmatic cavity separately. The analysis included 465 patients with the median follow-up duration of 121 months. Of these, 62 (13%) patients had positive pelvic cytology and 22 (5%) patients had positive right subdiaphragmatic cytology. Patients positive for right subdiaphragmatic cytology were all positive for pelvic cytology, showing the worst RFS and OS among the study population. Multivariate analyses showed positive right subdiaphragmatic cytology, not pelvic cytology, significantly correlated with shorter RFS and OS when adjusted for clinicopathological factors. Patients with both pelvic and right subdiaphragmatic positive cytology had significantly higher peritoneal recurrence rates than those negative at both sites. However, patients with only positive pelvic cytology showed no significant difference in the recurrence rate. Our results suggest that the prognostic significance of peritoneal cytology may differ depending on the collection site in endometrial cancer and provide new insights to select patients for adjuvant therapy. |
| format | Article |
| id | doaj-art-045f429748a149a28a77528e002670fe |
| institution | Kabale University |
| issn | 2045-2322 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Nature Portfolio |
| record_format | Article |
| series | Scientific Reports |
| spelling | doaj-art-045f429748a149a28a77528e002670fe2025-01-19T12:22:49ZengNature PortfolioScientific Reports2045-23222025-01-0115111010.1038/s41598-025-86784-4Prognostic significance of right subdiaphragmatic washing cytology in patients with endometrial cancerTakanori Yokoyama0Shinichi Okame1Mika Okazawa-Sakai2Etsuko Fujimoto3Yumi Hibino4Norihiro Teramoto5Kazuhiro Takehara6Department of Gynecologic Oncology, National Hospital Organization (NHO) Shikoku Cancer CenterDepartment of Gynecologic Oncology, National Hospital Organization (NHO) Shikoku Cancer CenterDepartment of Gynecologic Oncology, National Hospital Organization (NHO) Shikoku Cancer CenterDepartment of Gynecologic Oncology, National Hospital Organization (NHO) Shikoku Cancer CenterDepartment of Gynecologic Oncology, National Hospital Organization (NHO) Shikoku Cancer CenterDivision of Cancer Prevention and Epidemiology, Center for Cancer Research, National Hospital Organization (NHO) Shikoku Cancer CenterDepartment of Gynecologic Oncology, National Hospital Organization (NHO) Shikoku Cancer CenterAbstract Cancer cells in the right subdiaphragmatic lavage may reflect peritoneal dissemination, but its prognostic significance is unknown. This study investigated recurrence-free survival (RFS), overall survival (OS), and recurrence patterns in patients with curatively resected endometrial cancer by cytology collection site. Peritoneal cytology was collected at the beginning of surgery by washing the pelvic and right subdiaphragmatic cavity separately. The analysis included 465 patients with the median follow-up duration of 121 months. Of these, 62 (13%) patients had positive pelvic cytology and 22 (5%) patients had positive right subdiaphragmatic cytology. Patients positive for right subdiaphragmatic cytology were all positive for pelvic cytology, showing the worst RFS and OS among the study population. Multivariate analyses showed positive right subdiaphragmatic cytology, not pelvic cytology, significantly correlated with shorter RFS and OS when adjusted for clinicopathological factors. Patients with both pelvic and right subdiaphragmatic positive cytology had significantly higher peritoneal recurrence rates than those negative at both sites. However, patients with only positive pelvic cytology showed no significant difference in the recurrence rate. Our results suggest that the prognostic significance of peritoneal cytology may differ depending on the collection site in endometrial cancer and provide new insights to select patients for adjuvant therapy.https://doi.org/10.1038/s41598-025-86784-4Endometrial cancerSurgeryPeritoneal fluidPeritoneal cavityCytologyRecurrence |
| spellingShingle | Takanori Yokoyama Shinichi Okame Mika Okazawa-Sakai Etsuko Fujimoto Yumi Hibino Norihiro Teramoto Kazuhiro Takehara Prognostic significance of right subdiaphragmatic washing cytology in patients with endometrial cancer Scientific Reports Endometrial cancer Surgery Peritoneal fluid Peritoneal cavity Cytology Recurrence |
| title | Prognostic significance of right subdiaphragmatic washing cytology in patients with endometrial cancer |
| title_full | Prognostic significance of right subdiaphragmatic washing cytology in patients with endometrial cancer |
| title_fullStr | Prognostic significance of right subdiaphragmatic washing cytology in patients with endometrial cancer |
| title_full_unstemmed | Prognostic significance of right subdiaphragmatic washing cytology in patients with endometrial cancer |
| title_short | Prognostic significance of right subdiaphragmatic washing cytology in patients with endometrial cancer |
| title_sort | prognostic significance of right subdiaphragmatic washing cytology in patients with endometrial cancer |
| topic | Endometrial cancer Surgery Peritoneal fluid Peritoneal cavity Cytology Recurrence |
| url | https://doi.org/10.1038/s41598-025-86784-4 |
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