The Utility of Vaginal Pap Test in Patients with Endometrial Carcinoma Post Hysterectomy
Arivarasan Karunamurthy, Sarika Jain, Chengquan Zhao. University of Pittsburgh Medical Center, Pittsburgh, PA
Background: Endometrial cancer is the most common gynecologic malignancy in developed countries and surgery is the standard treatment. New screening guidelines does not emphasize if vaginal screening test is needed for patients with endometrial carcinoma after hysterectomy. Our aim was to evaluate the utility of the vaginal Pap test for women with endometrial carcinoma post hysterectomy.
Design: A retrospective review of all cases of endometrial carcinoma who underwent hysterectomy at our institution over a period of 17 months was performed to look at the clinical data, histological diagnosis at the time of surgery, cytological and histological follow-up results.
Results: A total of 227 patients underwent hysterectomy for endometrial carcinomas and the hystrectomy specimens included 120 (53%) endometrioid carcinoma, 26 (11%) serous carcinoma, 7 (3%) clear cell carcinoma, 3 (1%) malignant mixed mulerian tumor and 5 (2%) other types of carcinomas. The mean age of the patients was 62.3 years (range 27-91 years) and, 161 (71%) patients had vaginal histological and/or cytological results in our database during the follow-up period. The mean follow-up period was 43 months (range: 3 to 80 months) and the number of follow up Pap smears visits averaged 6.4 times (range: 1 to 16 times). The follow-up histological and cytological results were summarized in Table 1.
|Follow-up Histo-Cytological Results||(Total cases)||Carcinoma||VAIN2/3 & HSIL||VAIN1/LSIL||Atypical Squamous lesion||Negative|
|Total Cases||161 (100%)||2 (1%)||0||4 (2%)||18 (11%)||137 (85%)|