Saline Infusion Sonohysterography and the Risk of Malignant Extrauterine Spread in Endometrial Cancer

The aim of this study was to evaluate the incidence of tumor cell dissemination after saline infusion sonohysterography (SIS) in patients with endometrial cancer (EC). A retrospective study was conducted on 173 patients with EC in whom one of the following methods were performed: dilation and curettage (D&C, n = 120) and D&C followed by SIS (n = 53). No selection or randomization of patients was applied to both groups. The presence of positive peritoneal cytology, as well as adnexal or abdominal metastases was considered the endpoint of this analysis. Positive peritoneal cytology was present in one patient (0.8%) after D&C and in one patient (1.9%) after D&C followed by SIS (χ2 = 0.030; p > 0.05). Adnexal metastases were present in nine (7.5%) patients after D&C and in three (5.7%) patients after D&C followed by SIS (χ2 = 0.013; p > 0.05). Metastases to abdominal cavity were found in three (2.5%) patients after D&C and in two (3.8%) patients after D&C followed by SIS (χ2 = 0.001; p > 0.05). Upstaged because of positive cytology, adnexal or abdominal metastases were 13 patients (10.8%) after D&C and six patients (11.3%) after D&C followed by SIS (χ2 = 0.029; p > 0.05). These data show that SIS does not increase the risk of malignant cell dissemination in patients with EC. (E-mail: iztok.takac@sb-mb.si)