Challenges in Managing Patients with Hereditary Cancer at Gynecological Services

Table 2

“Malignant” or “suspicious for malignancy” on peritoneal washing cytology without macroscopic abnormality.

	Period of RRSO	SEE-FIM protocol	PWC in RRSO	Malignancy in PWC (macroscopic cancer)	Histopathologic examination	Further examination and follow-up therapy
Colgan [10]	NA	No	35	Malignant	Early stromal invasion of the ovarian cortex	Chemotherapy, 2nd look
				Malignant	STIC	Observation
				Malignant	NED	Extensive additional sectioning, reviewed by additional 2 cytopathologists, negative cytology at 2nd look, chemotherapy and 2nd look surgery
Manchanda [11]	2005–2009	No	308	Malignant	STIC	Hysterectomy, OMT + LND
				Malignant	STIC	Hysterectomy, OMT + LND
				Suspicious for malignancy	STIC	Hysterectomy, OMT + LND
Landon [12]	2000–2012	Mostly	117	Malignant	NED	Reviewed by additional 4 cytopathologists, multiple levels of tissue blocks examined, chemotherapy, 2nd look surgery
				Suspicious for malignancy	Ovarian endometriosis and endosalpingiosis	Observation
Powell [13]	1995–2009	NA	405	Malignant	NED	Hysterectomy, OMT
				Malignant	NED	Hysterectomy, OMT followed by 6 cycles of chemotherapy
				Malignant	NED	Hysterectomy, OMT + LND followed by 6 cycles of chemotherapy
Blok [14]	2000–2014	Since 2006	267	None
Total			1132	11 (1.0%)

SEE-FIM: sectioning and extensively examining the fimbriated; PWC: peritoneal washing cytology; and STIC: serous tubal intraepithelial carcinoma.