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

Zusammenfassung: Die Dauer der hysteroskopischen Untersuchung bei Endometrium-Carcinom (Gebärmutterschleimhaut-Krebs) hat keinen negativen Einfluss auf die Prognose.

Exp Ther Med. 2011 Sep;2(5):991-995. Epub 2011 Jun 30.

Tempfer C(1), Froese G, Buerkle B, Polterauer S, Grimm C, Concin N, Hofstetter G, Weigert M, Oehler MK.

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.