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Assessment of False-negative Ascites Cytology in Epithelial Ovarian Carcinoma: A Study of 313 Patients

Allen, Valerie A. MD; Takashima, Yoko MD; Nayak, Seema MD; Manahan, Kelly J. MD; Geisler, John P. MD

American Journal of Clinical Oncology: April 2017 - Volume 40 - Issue 2 - p 175–177
doi: 10.1097/COC.0000000000000119
Original Articles: Gynecologic

Objective: The objective was to determine how often peritoneal cytology is positive for malignancy in women with known ovarian cancer. Knowing this fact would help determine the usefulness of diagnostic paracentesis.

Methods: Records of all women diagnosed with invasive epithelial ovarian cancer from 2004 to 2012 were examined to correlate presence of ascites, cytologic, and pathologic findings.

Results: A total of 313 patients were included in analysis. A total of 210 of 313 patients (67.1%) with ascites had cytology positive for malignancy. This left 103 patients with ascites and cancer without malignant cells found in the ascites removed at the time of surgery.

Conclusions: Except in a few cases, paracentesis is not recommended for the diagnosis of ovarian cancer because of the potential spreading of cancer. Furthermore, with only just over two thirds of cases of known cancer and ascites having cytology positive for malignancy, the value of paracentesis for diagnosis of ovarian cancer is minimal.

Division of Gynecologic Oncology

*Department of Obstetrics and Gynecology, University of Toledo College of Medicine and Life Sciences, Toledo, OH

The authors declare no conflicts of interest.

Reprints: John P. Geisler, MD, UGR/University of Georgia Medical Partnership, Division of Gynecology Oncology, Athens Regional Medical Center, 1199 Prince Avenue #70, Athens, Georgia 30606. E-mail:

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