Role of fallopian tube and cervical canal occlusion in preventing intra-operative tumour spillage in early endometrial cancer - A pilot study

Sep 29, 2026

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Role of fallopian tube and cervical canal occlusion was evaluated to address intra-operative tumour spillage risk in early endometrial cancer, motivated by prior findings of post-hysterectomy atypical glandular cells in the upper vagina and their link to isolated vaginal recurrence. A prospective interventional single-institution pilot study used random allocation to compare cervical os and fallopian tube occlusion versus standard surgery, assessing vaginal smear and peritoneal wash cytology before and after hysterectomy. Results showed no negative-to-positive cytology conversion in either arm.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages8

Reading Time20 min

AccessFree to download

Abstract

Background

Methods

Results

Conclusion

Implications of this study

Background

Tumor spillage routes and recurrence context

Aparajita etal. World Journal of Surgical Oncology (2026) 24:12 [https://doi.org/10.1186/s12957-025-04121-5](https://doi.org/10.1186/s12957-025-04121-5) World Journal of Surgical Oncology RESEARCH Open Access Role of fallopian tube and cervical canal occlusion in preventing intra-operative tumour spillage in early endometrial cancera pilot study Aparajita 1*, Debabrata Barmon2, Upasana Baruah2, Dimpy Begum2 and Shiraj Ahmed3 Abstract Background Recent studies have found the presence of post-hysterectomy atypical glandular cells in upper vagina in ~ 30% patients of Endometrial Cancer (EC) with implications of causing isolated vaginal recurrence. The primary objective was to determine the effectiveness of cervical canal and fallopian tube occlusion in preventing intraoperative tumour spillage in EC. Methods A Prospective Interventional Single Institutional pilot study with random allocation to two arms using computer-generated random number sequence was conducted between January 2022 to Feb 2023. Patients with histologically confirmed epithelial endometrial cancer, including endometrioid carcinoma, papillary serous, clear-cell, squamous, mucinous, undifferentiated, and carcino-sarcoma with surgery as primary definitive treatment modality were included. Spillage was detected using vaginal smear and peritoneal wash cytology taken pre-and post-hysterectomy. In interventional arm, cervical os and fallopian tube were occluded using silk sutures as additional steps during surgery. Rate of negative to positive conversion of vaginal smear and peritoneal wash cytology obtained before and after hysterectomy in the interventional arm was compared with control arm who underwent surgery with standard surgical steps. Results: Out of 33 eligibile patients, 3 were excluded due to double primaries and history of radiation pelvis. The two arms of 15 patients each were comparable with respect to clinico-pathological characteristics. The most common histology, grade, degree of myometrial invasion, LVSI, stage, and mean tumour diameter was endometrioid variety (100%), low-grade (83 . 3%), & >1/2 (50%), negative (83 . 3%), 1 A (41 . 7%), and 4 cm in interventional arm and endometrioid (100%), low grade (76 . 9%), >1/2 (84 . 6%), negative (92 . 3%), 1B (84 . 6%), and 4.5 cm in non-interventional arm respectively. None of the patient in either arm had negative to positive conversion of vaginal and/or peritoneal cytology. Conclusion: We observed no difference of cervical and tubal occlusion on tumour cell spillage in EC. Trial registration CTRI/2022/05/042348 . *Correspondence: Aparajita [alka02oct@gmail.com](alka02oct@gmail.com) Full list of author information is available at the end of the article © The Author(s) 2025. Open Access This article is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License, which permits any non-commercial use, sharing, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if you modified the licensed material. You do not have permission under this licence to share adapted material derived from this article or parts of it. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit [http://creati](http://creati)[vecommons.org/l](vecommons.org/l)icenses/by-nc-nd/4.0/. Aparajita et al. World Journal of Surgical Oncology (2026) 24:12 Page 2 of 8 Keywords Endometrial cancer, Intra-operative tumour spillage, Vaginal recurrence, Intra

FAQs

What was the primary objective of the pilot study?

To determine the effectiveness of cervical canal and fallopian tube occlusion in preventing intra-operative tumour spillage in early endometrial cancer.

How did the study detect intra-operative tumour spillage?

It used vaginal smear and peritoneal wash cytology collected pre- and post-hysterectomy to assess cytology conversion.

What were the main findings regarding cervical and tubal occlusion?

No negative-to-positive conversion of vaginal and/or peritoneal cytology occurred in either arm, and the study observed no difference of cervical and tubal occlusion on tumour cell spillage.

Sep 29, 2026

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