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Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license.  \n1 Department of Obstetrics and Gynecology, Diyarbakir Gazi Yasargil Training and Research Hospital, Diyarbakir 21070, Turkey  \n2 Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Diyarbakir Gazi Yasargil Training and Research Hospital, Diyarbakir 21070, Turkey  \n3 Merz Aesthetics GmbH, 60318 Frankfurt am Main, Germany  \n4 Department of Obstetrics and Gynecology, Marmara University Hospital, Istanbul 34899, Turkey  \n* Correspondence: [dr.kubracakar@gmail.com](dr.kubracakar@gmail.com)  \nAbstract  \nObjectives: The endometrium and cervix share a common Müllerian origin and may exhibit overlapping biological responses to oncogenic stimuli. However, the clinical significance of preoperative cervical cytology in patients with endometrial cancer remains unclear. This study aimed to investigate the association between preoperative cervical smear cytology and clinicopathologic characteristics, with particular emphasis on advanced FIGO stage (III–IV) as the primary outcome. Methods: This retrospective cohort study included 154 patients who underwent primary surgery for histologically confirmed endometrial cancer. Preoperative cervical smear cytology was classified according to the Bethesda System into four categories: normal, low-grade, high-grade, and malignant. For subgroup analyses, low-grade, high-grade, and malignant cytology results were combined and compared with normal cytology. FIGO stage was analyzed both as individual stages (IA–IV) and as early-stage (I–II) versus advanced-stage (III–IV) disease, where appropriate. Continuous variables were summarized as mean ± standard deviation or median (interquartile range), while categorical variables were expressed as n (%) . Group comparisons were performed using the Pearson chi-square test or Fisher’s exact test, as appropriate, and a two-sided p value \u003C 0.05 was considered statistically significant. Results: A total of 154 patients with endometrial cancer were included in the analysis. Preoperative cervical smear cytology was normal in 140 patients (90.9%), low-grade in 6 (3.9%), high-grade in 3 (1.9%), and malignant in 5 (3.2%) . Comparison across cytology categories demonstrated a significant association between smear cytology and FIGO stage (p \u003C 0.001), with highgrade and malignant cytology occurring more frequently in patients with advanced-stage disease. Vaginal cuff involvement was also significantly associated with smear cytology (p = 0.001), whereas no significant associations were observed for myometrial invasion, lymphovascular space invasion, cervical stromal involvement, tubo-ovarian involvement, omental involvement, or lymph node metastasis. Subgroup analysis comparing normal and abnormal cytology yielded similar findings, confirming significant associations with FIGO stage (p \u003C 0.001) and vaginal cuff involvement (p = 0.002) . In a multivariable model additionally including cervical cytology, LVSI and deep myometrial invasion were independent predictors of advanced stage (AUC = 0.888), whereas cytology was not statistically significant after adjustment (OR 4.51, p = 0.076) and showed poor standalone diagnostic performance (AUC = 0.564, sensitivity 19.4%, specificity 93.5%) . All patients with vaginal cuff involvement had advanced-stage disease (Fisher’s exact p \u003C 0.001) . The cytology–FIGO stage association was not significant in postmenopausal (p = 0.065) or endometrioid-only (p = 1.00) subgroup analyses. Conc","cbCaiqRGSvWZeLR3","https://ap.wps.com/l/cbCaiqRGSvWZeLR3","pdf",236344,13,"English","# Abstract\n## Objectives\n## Methods\n## Results\n## Conclusions\n# 1. Introduction","[{\"question\":\"What was the study’s primary goal regarding cervical smear cytology?\",\"answer\":\"To determine the association between preoperative cervical smear cytology and clinicopathologic characteristics in endometrial cancer, with a focus on advanced FIGO stage (III–IV).\"},{\"question\":\"How were cervical smear results categorized in the study?\",\"answer\":\"Preoperative cervical smear cytology was classified using the Bethesda System into normal, low-grade, high-grade, and malignant categories.\"},{\"question\":\"What associations were found between cervical cytology and disease severity?\",\"answer\":\"Abnormal preoperative cervical smear cytology was significantly associated with advanced FIGO stage and vaginal cuff involvement. After multivariable adjustment, cytology was not an independent predictor and showed poor standalone diagnostic performance.\"}]","Preoperative Cervical Smear Cytology and Clinicopathologic Characteristics in Endometrial Cancer | PDF",1790132995,33]