caa a22 4500 445310995 CHVBK 20180317142629.0 cr unu---uuuuu 170323e20111101xx s 000 0 eng 10.1007/s00404-011-2031-6 doi (NATIONALLICENCE)springer-10.1007/s00404-011-2031-6 Iatrogenic transtubal spill of endometrial cancer: risk or myth [Elektronische Daten] [Onur Guralp, David Kushner] Introduction: Although intrauterine procedures are essential for endometrial evaluation in many cases, the significance of the amount of tumor cell dissemination during these procedures, the viability and invasive potential of the endometrial cancer (EC) cells, and their impact on prognosis remain elusive. Materials and methods: An extensive search was performed in the Cochrane Central Trials Registry, the Web of Science, and PubMed for publications about the role of hysteroscopy (H/S), saline infusion sonography (SIS) and laparoscopy (L/S) in dissemination of EC cells and prognostic significance of positive peritoneal washings (PPW), between 1988 and 2010 and English language. All eligible trials were included. Conclusion: PPW rates vary between 0-14% after dilatation and curettage (D&C), 0-83% after H/S, 0-10% after L/S and 12-52% after SIS. The majority of the studies about EC cell dissemination during H/S and SIS suggest that they increase the risk of spill. There is not enough evidence to support the association between tumor spill and pressure, type and volume of distension medium, duration of the procedure, stage, grade and interval between H/S or SIS and laparotomy. Investigation into the rate of spill of EC cells during laparoscopic surgery is in the early stages and not yet definitive. There are too few in vivo and in vitro studies to comment definitively on the viability of the disseminated EC cells. The limited data we do have, however, questions the ability of disseminated EC cells to maintain and grow. Most published studies support the idea that prognosis is not affected by PPW in stage I EC. The changes in FIGO 2009 staging of EC appears to have merit when considering the sum of the data. H/S and SIS probably increase the risk of spill, however this increase does not seem effect prognosis. Although peritoneal washings are still expected to be performed, PPW itself does not necessitate additional treatment. Springer-Verlag (outside the USA), 2011 Hysteroscopy nationallicence Saline infusion sonography nationallicence Sonohysterosalphingography nationallicence Laparoscopy nationallicence Endometrial cancer nationallicence Endometrial carcinoma cell dissemination nationallicence Cell seeding nationallicence Guralp Onur Cerrahpasa School of Medicine, Obstetrics and Gynecology, Istanbul University, Akademiler Sitesi, B/37 Kat. 8, Zincirlikuyu, Besiktas, Istanbul, Turkey aut Kushner David Division of Gynecologic Oncology, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA aut Archives of Gynecology and Obstetrics Springer-Verlag 284/5(2011-11-01), 1209-1221 0932-0067 284:5<1209 2011 284 404 https://doi.org/10.1007/s00404-011-2031-6 text/html Onlinezugriff via DOI 1 review-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s00404-011-2031-6 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Guralp Onur Cerrahpasa School of Medicine, Obstetrics and Gynecology, Istanbul University, Akademiler Sitesi, B/37 Kat. 8, Zincirlikuyu, Besiktas, Istanbul, Turkey aut NATIONALLICENCE 700 1- Kushner David Division of Gynecologic Oncology, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA aut NATIONALLICENCE 773 0- Archives of Gynecology and Obstetrics Springer-Verlag 284/5(2011-11-01), 1209-1221 0932-0067 284:5<1209 2011 284 404 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer