{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T16:12:18Z","timestamp":1787069538744,"version":"build-2736575974"},"reference-count":36,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2017,12,27]],"date-time":"2017-12-27T00:00:00Z","timestamp":1514332800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cytopathology"],"published-print":{"date-parts":[[2018,2]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>\n                      Abnormal cervical cytology in patients with endometrial cancer (\n                      <jats:styled-content style=\"fixed-case\">EC<\/jats:styled-content>\n                      ) has been associated with poor outcome. The aim of this study was to evaluate whether cervical cytology could contribute to an improved preoperative identification of high\u2010grade\n                      <jats:styled-content style=\"fixed-case\">EC<\/jats:styled-content>\n                      (serous, clear cell, carcinosarcoma, high\u2010grade endometrioid\n                      <jats:styled-content style=\"fixed-case\">EC<\/jats:styled-content>\n                      ) in final histology.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      A retrospective cohort study was performed in five hospitals in the Netherlands. A total of 554 patients with\n                      <jats:styled-content style=\"fixed-case\">EC<\/jats:styled-content>\n                      that underwent primary surgical treatment between 2002 and 2010 were included. Primary outcome was defined as the contribution of abnormal cervical cytology in the preoperative identification of high\u2010grade\n                      <jats:styled-content style=\"fixed-case\">EC<\/jats:styled-content>\n                      . As secondary outcome, recurrence\u2010free survival (\n                      <jats:styled-content style=\"fixed-case\">RFS<\/jats:styled-content>\n                      ) and disease\u2010specific survival were determined based on preoperative cervical cytology, and compared to the currently established risk factors: myometrial invasion, high\u2010grade and lymph vascular space invasion.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Abnormal cervical cytology was present in 45.1%. For patients with preoperative inconclusive and high\u2010grade histology, the presence of abnormal cervical cytology contributed to an improved identification of high\u2010grade\n                      <jats:styled-content style=\"fixed-case\">EC<\/jats:styled-content>\n                      in final histology (odds ratio [\n                      <jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>\n                      ] 6.40 [95% confidence interval {\n                      <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\n                      }: 1.92\u201021.26];\n                      <jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>\n                      2.86 [95%\n                      <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\n                      : 1.14\u20107.14]), respectively.\n                    <\/jats:p>\n                    <jats:p>\n                      Patients with abnormal cervical cytology had a significant worse 5\u2010year median\n                      <jats:styled-content style=\"fixed-case\">RFS<\/jats:styled-content>\n                      . Abnormal cervical cytology was independently related to\n                      <jats:styled-content style=\"fixed-case\">RFS<\/jats:styled-content>\n                      (hazard ratio 1.67 [95%\n                      <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\n                      : 1.04\u20102.68]) and disease\u2010specific survival (hazard ratio 3.15 [95%\n                      <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\n                      : 1.74\u20105.71]).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      Abnormal cytology contributes to the preoperative identification of patients with high\u2010grade\n                      <jats:styled-content style=\"fixed-case\">EC<\/jats:styled-content>\n                      , and is associated with compromised outcome. Future studies are warranted to determine whether cervical cytology could be incorporated into preoperative prediction models for lymph node metastasis.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/cyt.12511","type":"journal-article","created":{"date-parts":[[2017,12,27]],"date-time":"2017-12-27T04:44:34Z","timestamp":1514349874000},"page":"63-70","source":"Crossref","is-referenced-by-count":13,"title":["Contribution of cervical cytology in the diagnostic work\u2010up of patients with endometrial cancer"],"prefix":"10.1111","volume":"29","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7595-2688","authenticated-orcid":false,"given":"L. C. M.","family":"Amkreutz","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology Zuyderland Medical Centre Sittard\u2010Geleen and Heerlen The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. M. A.","family":"Pijnenborg","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Radboud University Medical Center Nijmegen The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D. W. L.","family":"Joosten","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Zuyderland Medical Centre Sittard\u2010Geleen and Heerlen The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H. J. M. M.","family":"Mertens","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Zuyderland Medical Centre Sittard\u2010Geleen and Heerlen The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S. M. J.","family":"Van Kuijk","sequence":"additional","affiliation":[{"name":"KEMTA\u2010Clinical Epidemiology and Medical Technology Assessment Maastricht University Medical Centre Limburg The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M. J. A.","family":"Engelen","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Zuyderland Medical Centre Sittard\u2010Geleen and Heerlen The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Bergmans","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Sint Laurentius Hospital Roermond The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"W. E.","family":"Nolting","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology SJG Weert Weert The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R. F. P. 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