1106 Is vaginal cytology necessary in the follow-up of endometrial cancer?

Introduction/Background Endometrial cancer (EC) is a commonly seen gynecological malignancy in women. In the past, vaginal cytology, which was used in the follow-up of endometrial cancer, is now abandoned. The primary aim of the study is to retrospectively examine the effectiveness of vaginal cytology in detecting recurrent EC in patients who were operated in our center. Methodology The study includes patients who underwent surgery at our center, were diagnosed with EC, and had at least one smear taken during their postoperative follow-up. The samples were evaluated according to the Bethesta classification by pathologists at our center. Both imaging methods and pathological examinations were used to identify recurrences. Results A total of 279 patients were examined in our study. Preoperative and postoperative findings are summarized in table-1. Recurrence (local or distant) was detected in 12.5% (n=35) of the patients during follow-up. A total of 1131 vaginal cytology samples were taken during the post-operative follow-up of 279 patients. Epithelial cell anomalies were detected in a total of 24 smear results in 17 patients (2.1%) (Table-1). Out of the 17 patients with anomalies detected in vaginal smear cytology, only 2 were diagnosed with recurrent disease. When comparing the rates of abnormal detection in vaginal cytology between groups with and without recurrent disease, no significant difference was found (p=0.639). Among the patients with recurrent disease in the vaginal cuff (10 patients), only one had an abnormal cytology result. There was no significant difference in the presence of abnormal cytology between the group with vaginal cuff recurrence and the group without cuff recurrence (p = 0.472). Conclusion In our study, patients with endometrial cancer recurrence, there was no demonstrated clinical benefit in the follow-up with vaginal smear. This finding shows that the vaginal smear method does not provide sufficient sensitivity in detecting relapse and is consistent with the literature. Disclosures All authors declare that they have no conflicts of interest.