The significance of cytological mesothelial atypia diagnosed from peritoneal washings performed during risk-reducing salpingo-oophorectomy Journal Article


Authors: Eitan, R.; Soslow, R.; Lin, O.; Kauff, N. D.; Liu, L.; Barakat, R. R.; Chi, D. S.
Article Title: The significance of cytological mesothelial atypia diagnosed from peritoneal washings performed during risk-reducing salpingo-oophorectomy
Abstract: Objective.: Occult cancer may be found in a small proportion of women undergoing risk-reducing salpingo-oophorectomy (RRSO). However, the results and significance of peritoneal wash cytology in this setting are not clear. The objective of this study was to determine the significance of cytologic mesothelial atypia in the peritoneal washings of patients undergoing RRSO. Methods.: We conducted a retrospective chart review of all patients undergoing RRSO from July 2002 to December 2003. Patient charts were reviewed for information regarding cytology, pathology, demographics, surgical procedure and findings, and outcome. Results.: One hundred thirty women underwent RRSO during the study period. One hundred seventeen had washings performed during the procedure and constitute the study cohort. The median age at the time of the procedure was 48 years (range, 33-78 years). Final cytology was reported as normal in 102 patients (87%), mesothelial atypia in 13 (11%), and non-satisfactory in 2 (2%). Ovarian and tubal histopathology was normal in all cases. No association was found between mesothelial atypia and age, prior breast cancer, or prior abdominal surgery. Twenty-nine patients had previously undergone genetic testing for BRCA1/2 mutations as part of ongoing prospective follow-up studies. Four (24%) of 17 patients with a known BRCA1 or BRCA2 mutation were found to have mesothelial atypia compared to 1 (8%) of 12 with no mutation. With a median follow-up time of 20 months (range, 1-40 months), none of the patients with mesothelial atypia were diagnosed with peritoneal malignancy following RRSO. Conclusion.: In this study, mesothelial atypia was identified in 11% of patients who had peritoneal washings performed at the time of RRSO. No patients with mesothelial atypia went on to develop peritoneal carcinoma. The link between mesothelial atypia and mutations in BRCA1/2 and the need to perform peritoneal washings in this setting are both yet to be determined. © 2005 Elsevier Inc. All rights reserved.
Keywords: adult; controlled study; human tissue; aged; middle aged; surgical technique; retrospective studies; gene mutation; major clinical study; histopathology; outcome assessment; follow up; salpingooophorectomy; ovarian cancer; ovarian neoplasms; cytology; demography; peritoneum cancer; peritoneal neoplasms; breast cancer; ovariectomy; cohort analysis; brca1 protein; brca2 protein; medical information; statistical significance; genes, brca1; genes, brca2; abdominal surgery; epithelium; risk reduction; genetic procedures; brca1; brca2; peritoneum; risk-reducing salpingo-oophorectomy; peritoneal cavity; mesothelium; peritoneal washings; mesothelial atypia
Journal Title: Gynecologic Oncology
Volume: 102
Issue: 2
ISSN: 0090-8258
Publisher: Elsevier Inc.  
Date Published: 2006-08-01
Start Page: 315
End Page: 318
Language: English
DOI: 10.1016/j.ygyno.2005.12.021
PUBMED: 16430946
PROVIDER: scopus
DOI/URL:
Notes: --- - "Cited By (since 1996): 4" - "Export Date: 4 June 2012" - "CODEN: GYNOA" - "Source: Scopus"
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MSK Authors
  1. Richard R Barakat
    629 Barakat
  2. Dennis S Chi
    707 Chi
  3. Noah Kauff
    128 Kauff
  4. Oscar Lin
    307 Lin
  5. Robert Soslow
    793 Soslow
  6. Lisa Liu
    2 Liu