Hysteroscopy Not Implicated In Endometrial Ca Recurrence


SANTA MONICA, CALIF. — While hysteroscopy is the most accurate tool for evaluating abnormal uterine bleeding, the technique can cause the intraperitoneal spread of malignant endometrial cells. This has raised concerns that hysteroscopy might be responsible for a worse prognosis in women with endometrial cancer.

But in a poster presentation at the biennial meeting of the International Gynecologic Cancer Society, Dr. A. Ben Arie and colleagues found no evidence that hysteroscopy was associated with an increase in endometrial cancer recurrences.

The retrospective study involved 392 women provisionally diagnosed with stage I endometrial adenocarcinoma at five medical centers in Israel. Dr. Ben Arie of Kaplan Medical Center, Rehovot, Israel, and colleagues examined the women's medical records, retrieving data on mode of diagnosis, histologic type, grade and stage of the disease, and the patient's outcome.

Three different diagnostic methods were employed in the women—25% had an endometrial biopsy, 49% had uterine curettage, and 26% had hysteroscopy. Endometrial adenocarcinoma was found in 88.5% of the women, and the other 11.5% had uterine serous papillary cancer, clear cell cancer, or small cell cancer. The cancer was stage I in 81% of the women, stage II in 2% of the women, and stage III in 17% of the women.

At a mean follow-up time of 55 months (range 12–233 months), recurrences were found in 5% of the women who had hysteroscopy, 4.7% of the women who had curettage, and 13.1% of the women who had endometrial biopsy. There was no statistically significant difference in the recurrence rate among the three diagnostic methods.

The investigators concluded that hysteroscopy is safe in the assessment of abnormal uterine bleeding.

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