The Impact of Cervical Pap Smear on the Prognostic Risk Groups of Endometrial Carcinoma

Objective: To investigate the importance of preoperative cervical Pap smear in patients with endometrial cancer and the impact of it on the prognostic risk groups of endometrial cancer. Methods: The preoperative cervical cytology results of 423 patients who underwent staging surgery for endometrial cancer between the years of 2010 and 2020 in the gynecological oncology clinic of the tertiary center were examined in a retrospective observational study. The relations between cervical Pap smear results and pathological prognostic factors of endometrial cancer such as tumor histology, tumor size, FIGO grade, lymphovascular space invasion and FIGO stage were evaluated in details. The impact of cervical cytology results in the prognostic risk groups (molecular classification unknown) specified in the ESGO/ESTRO/ESP (2020) guideline was also examined. SPSS version 25.0 program was used in the analysis of the data. Results: Abnormal cervical Pap cytology was present in 12.1% (n= 51) of the patients included in the study. Significantly more abnormal cervical cytology was observed in the high prognostic risk groups (p= 0.017), tumors with non-endometrioid histologic types (p= 0.001), and patients with adnexal involvement (p= 0.007). In the subgroup analysis of endometrioid type endometrial adenocarcinomas, as the FIGO grade increased, the rate of abnormal cervical cytology increased significantly (p= 0.014). Conclusions: Pre-operative cervical cytology abnormality may predict the need for intra-operative systematic surgical staging and postoperative adjuvant therapy.