Evidence map›Paper›PMID 40300979›Full record

ArticleInternational journal of gynecological cancer : official journal of the International Gynecological Cancer Society2025

Rewinding the clock on positive peritoneal cytology in endometrial cancer: does it predict prognosis in low-risk disease?

Diletta Fumagalli, Emilia Palmieri, Giuseppe Caruso, Luigi A De Vitis, Ilaria Capasso, Benoit Guillot, Giulia Pappalettera, Tommaso Occhiali, Angela J Fought, Michaela E McGree and 4 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in International journal of gynecological cancer : official journal of the International Gynecological Cancer Society, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors.

Diletta FumagalliMayo Clinic, Department of Obstetrics and Gynecology, Division of Gynecologic Surgery, Rochester, MN, USA; European Institute of Oncology (IEO) IRCCS, Department of Gynecology, Milan, Italy.
Emilia PalmieriMayo Clinic, Department of Obstetrics and Gynecology, Division of Gynecologic Surgery, Rochester, MN, USA; Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Department of Women, Children and Public Health Sciences, Gynecologic Oncology Unit, Roma, Italy.
Giuseppe CarusoMayo Clinic, Department of Obstetrics and Gynecology, Division of Gynecologic Surgery, Rochester, MN, USA; European Institute of Oncology (IEO) IRCCS, Department of Gynecology, Milan, Italy.
Luigi A De VitisMayo Clinic, Department of Obstetrics and Gynecology, Division of Gynecologic Surgery, Rochester, MN, USA; European Institute of Oncology (IEO) IRCCS, Department of Gynecology, Milan, Italy.
Ilaria CapassoMayo Clinic, Department of Obstetrics and Gynecology, Division of Gynecologic Surgery, Rochester, MN, USA; Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Department of Women, Children and Public Health Sciences, Gynecologic Oncology Unit, Roma, Italy.
Benoit GuillotMayo Clinic, Department of Obstetrics and Gynecology, Division of Gynecologic Surgery, Rochester, MN, USA; European Institute of Oncology (IEO) IRCCS, Department of Gynecology, Milan, Italy.
Giulia PappaletteraMayo Clinic, Department of Obstetrics and Gynecology, Division of Gynecologic Surgery, Rochester, MN, USA; European Institute of Oncology (IEO) IRCCS, Department of Gynecology, Milan, Italy.
Tommaso OcchialiMayo Clinic, Department of Obstetrics and Gynecology, Division of Gynecologic Surgery, Rochester, MN, USA; Azienda Sanitaria Universitaria Friuli Centrale, Santa Maria della Misericordia University Hospital, Clinic of Obstetrics and Gynecology, Udine, Italy.
Angela J FoughtMayo Clinic, Department of Quantitative Health Sciences, Division of Clinical Trials and Biostatistics, Rochester, MN, USA.
Michaela E McGreeMayo Clinic, Department of Quantitative Health Sciences, Division of Clinical Trials and Biostatistics, Rochester, MN, USA.
Carrie LangstraatMayo Clinic, Department of Obstetrics and Gynecology, Division of Gynecologic Surgery, Rochester, MN, USA.
Evelyn ReynoldsMayo Clinic, Department of Obstetrics and Gynecology, Division of Gynecologic Surgery, Rochester, MN, USA.
Andrea MarianiMayo Clinic, Department of Obstetrics and Gynecology, Division of Gynecologic Surgery, Rochester, MN, USA.
Gretchen E GlaserMayo Clinic, Department of Obstetrics and Gynecology, Division of Gynecologic Surgery, Rochester, MN, USA. Electronic address: Glaser.gretchen@mayo.edu.

Funding

Use of microfluidic tumor cultures to enable clinical trials of therapies for ovarian cancerP50CA136393 · NCI · MAYO CLINIC ROCHESTER · PI ELLEN L. GOODE · 2009 to 2026
$37.0M
NCI NIH HHS P50 CA136393
6 · The paper itself

Abstract

objectivePositive peritoneal cytology in endometrial cancer is a known risk factor for worse oncologic outcomes but is not used for staging purposes or to guide adjuvant treatment. Additionally, its prognostic impact on low-risk patients remains unclear. Therefore, we investigated the role of positive peritoneal cytology in patients with endometrial cancer and focused on low-risk disease.

methodsThis is a retrospective cohort study including all consecutive patients undergoing primary surgery for endometrial cancer at Mayo Clinic from 1999 to 2021. The role of positive peritoneal cytology was investigated in the entire cohort and in 2 subgroups: the National Comprehensive Cancer Network (NCCN) low-risk group, including low-risk patients according to NCCN guidelines (endometrioid, grade 1-2, stage IA) and the European Society of Gynecologic Oncology/European Society of Radiotherapy and Oncology/European Society of Pathology (ESGO/ESTRO/ESP) low-risk group, including low-risk patients according to ESGO/ESTRO/ESP guidelines (as NCCN, plus no lymphovascular space invasion). Univariate and multivariable analyses were used to evaluate the association of positive peritoneal cytology with recurrence within 5 years after surgery, and Kaplan-Meier survival analyses were performed in all groups.

resultsA total of 3517 patients were included, 1911 in the NCCN low-risk group and 1832 in the ESGO/ESTRO/ESP low-risk group. Positive peritoneal cytology was found in 15.9% of the entire cohort (559/3517), 8.1% of the NCCN low-risk group (154/1911), and 7.9% of the ESGO/ESTRO/ESP low-risk group (145/1832). In both low-risk groups, 5-year recurrence-free survival was worse in patients with positive peritoneal cytology (p < .01 and p = .03, respectively), but there was no difference in overall survival. On univariate analysis, age, tumor grade, and positive peritoneal cytology were significant predictors of recurrence in both subgroups. After multivariable analysis, positive peritoneal cytology remained independently associated with recurrence (p < .01 and p = .03, respectively).

conclusionsPositive peritoneal cytology was an independent predictor of recurrence and was associated with worse recurrence-free survival in patients with low-risk endometrial cancer. However, overall survival was not impacted.

Indexed as

Endometrial NeoplasmsPeritoneumAdultAgedAged, 80 and overFemaleHumansMiddle AgedNeoplasm Recurrence, LocalPrognosisRetrospective StudiesCytologyEndometrial CancerGynecologic NeoplasmsGynecologic SurgeryPeritoneal Washing

Identifiers

PMID40300979
PMCPMC12767496

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