Objective: This study aimed to evaluate the usability of peritoneal swabbing cytology (PSC) with cotton swabs as an effective method for the detection of peritoneal metastasis during the staging laparotomy of epithelial ovarian carcinomas and borderline tumours (EOC/BT). Study Design: One hundred and ninety-two patients with EOC/BT who underwent laparotomy at the Yokohama City University Hospital from 2004 to 2010 were analysed retrospectively. The positive rates of the PSC and ascites/peritoneal-wash cytology (A/PWC) were compared. Results and Conclusion: Both A/PWC and PSC were performed during laparotomy (n = 140). The rate of metastasis detection with A/PWC was significantly higher than with PSC (50.0 vs. 20.7%, p < 0.001 by χ2 test). The superior detection ability of A/PWC was observed regardless of the presence of macroscopic peritoneal metastasis in 56 cases with macroscopic peritoneal metastasis, with A/PWC detecting 80.3% of cases versus PSC detecting 37.5% (p = 0.013). In 84 cases without macroscopic peritoneal metastasis, A/PWC detected 29.8% of cases versus 9.5% with PSC (p = 0.003). Our results suggest that PSC is insufficient to evaluate the peritoneal metastasis for the surgical staging of EOC/BT. Other procedures such as subdiaphragmatic A/PWC should be included when possible to maximize the accuracy of diagnosis.

1.
Keetel WC, Elkin HB: Experience with radioactive colloidal gold in the treatment of ovarian carcinoma. Am J Obstet Gynecol 1956;71:553-568.
2.
Creasman WT, Rutledge F: The prognostic value of peritoneal cytology in gynecologic malignant disease. Am J Obstet Gynecol 1971;110:773-781.
3.
Simojoki M, Santala M, Vuopala S, Kauppila A: The prognostic value of peritoneal cytology in ovarian cancer. Eur J Gynaecol Oncol 1999;20:357-360.
4.
Zuna RE, Behrens A: Peritoneal washing cytology in gynecologic cancers: long-term follow-up of 355 patients. J Natl Cancer Inst 1996;17:980-987.
5.
William J, Hoskins MD: Epithelial ovarian carcinoma: principles of primary surgery. Gynecol Oncol 1994;55:S91-S96.
6.
National Comprehensive Cancer Network: Epithelial ovarian cancer: clinical practice guidelines in oncology. J NCCN 2011;9:82-113.
7.
Verleye L, Ottevanger PB, van der Graaf W, Reed NS, Vergote I; Gynaecological Cancer Group (GCG) of European Organisation for Research and Treatment of Cancer (EORTC): EORTC-GCG process quality indicators for ovarian cancer surgery. Eur J Cancer 2009;45:517-526.
8.
Japan Society of Obstetrics and Gynecology: The General Rules for Clinical Management of Ovarian Tumors, section 1, ed 2. Toyko, Kanehara Shuppan, 1997.
9.
Gynecologic Oncology Committee of Japan Society of Obstetrics and Gynecology: Annual report on gynecologic cancer patients 2010. ACTA Obstetr Gynaecol Japon 2012;3:1029-1077.
10.
Carmignani CP, Sugarbaker TA, Bromley CM, Sugarbaker PH: Intraperitoneal cancer dissemination: mechanisms of the patterns of spread. Cancer Metastasis Rev 2003;22:465-472.
11.
Stanojevic Z, Rancic G, Radic S, Potić-Zečević N, Đorđević B, Marković M, Todorovska I: Pathogenesis of malignant ascites in ovarian cancer patients. Arch Oncol 2004;12:115-118.
12.
Timmers PJ, Zwinderman K, Coens C, Vergote I, Trimbos JB: Lymph node sampling and taking of blind biopsies are important elements of the surgical staging of early ovarian cancer. Int J Gynecol Cancer 2010;20:1142-1147.
13.
Powless CA, Bakkum-Gamez JN, Aletti GD, Cilby WA: Random peritoneal biopsies have limited value in stating of apparent early stage epithelial ovarian cancer after thorough exploration. Gynecol Oncol 2009;115:86-89.
14.
Petignat P, Vajda D, Joris F, Obrist R: Surgical management of epithelial ovarian cancer at community hospitals: a population-based study. J Surg Oncol 2000;75:19-23.
15.
Ahmed FY, Wiltshaw E, A'Hern RP, Nicol B, Shepherd J, Blake P, Fisher C, Gore ME: Natural history and prognosis of untreated stage I epithelial ovarian carcinoma. J Clin Oncol 1996;14:2968-2975.
16.
Eltabbakh GH, Mount SL: Comparison of diaphragmatic wash and scrape specimens in staging of women with ovarian cancer. Gynecol Oncol 2001;81:461-465.
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.