Accuracy of cytologic diagnosis in the treated cancer patient

Edited

by

LOUIS

M.

HELLMAN,

M.D.

Selected abstracts recurrence in this group which was discovered by cytological examination. There were 195 cases of proved recurrent carcinoma of the cervix within a 5 year period. Of these, there were 86 cases that had involvement of the pelvic wall or distant metastases and, of course, in these the cytologic material from the vagina was negative. In those cases with obvious clinical Iocal recurrence or unsuspected local recurrence, there were 96 cases; 32 per cent of the clinically obvious had positive smears. The above indicates the importance of the accuracy of the vaginal smear in the discovery of recurrent lesions. The author concludes that the vaginal smear is a useful tool in the detection of recurrence in the patient who has been treated for cancer of the cervix, corpus, or vulva. It is possible to discover recurrence at a time when they are still amenable to treatment. Five year survivals after recurrence can be achieved if the recurrences are discovered early. Thirty-three per cent of local recurrences in cancer of the cervix were discovered by the use of routine cytology in the treated patient. Postoperative vaginal smears are helpful in both cancer of the cervix and cancer of the vulva. The cytologic method is of practical value in determining the adequacy of the clinical procedure in cancer of the vulva where control of the disease depends on wide local excision. J. Edward Hall

Actu cytologica Vol 8, No. 1, January-February, 1964. *Graham, Ruth M.: Accuracy of Cytologic Diagnosis in the Treated Cancer Patient, p. 3. *Way, Stanley: Microinvasive Carcinoma of the Cervix, p. 14. Yaspersson, Olle: Quantitative Cytochemical Studies on Normal Malignant, Premalignant and Atypical Cell Populations from the Human Uterine Cervix, p. 45. Graham:

Accuracy of Cytologic Diagnosis in the Treated Cancer Patient, p. 3. The author divided the cases studied into those treated more than 10 years previously, namely, between the years 1927 and 1953, and those treated with radiation therapy within the last 5 years. There were 803 patients with invasive cancer of the cervix, treated more than 10 years previously, Of these 803, 60 (7 per cent), had a proved recurrence after the tenth year. The majority of these recurrences were local as indicated by the fact that 45 (75 per cent) had malignant cells in the vaginal smear. Twelve of these cases were detected by cytological examination before the patient had any symptoms suggestive of recurrence. Twenty per cent of all recurrences after the tenth year were discovered by examination of the vaginal smear. Of 248 cases of carcinoma of the corpus, 16 had recurrences after 10 years. Malignant cells were found in the vaginal smear of 10 (63 per cent) of these cases. There were 30 patients who had been treated for carcinoma of the vulva more than 10 years previously. There was one

*These

articles

have

Way:

Microinvasive Carcinoma of the Cervix, p. 14. The author presents a small article on the use of exfoliative cytology in discovering microcarcinema of the cervix. He defines this lesion as a condition of the cervix where it does not appear malignant, and where there are no svmpe

been abstracted.

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