Abstract
To evaluate the agreement between the histopathological diagnoses of preoperative endometrial samples and surgical specimens and correlate the agreement between the diagnoses with the impact on surgical management and the survival of patients with endometrial adenocarcinomas. Sixty-two patients treated for endometrial cancer at a university hospital from 2002 to 2011 were retrospectively evaluated. The histopathological findings of preoperative endometrial samples and of surgical specimens were analyzed. The patients were subjected to hysterectomy as well as adjuvant treatment, if necessary, and clinical follow-up, according to the institutional protocol. Lesions were classified as endometrioid tumor (type 1) grades 1, 2, or 3 or non-endometrioid carcinoma (type 2). The agreement between the histopathological diagnoses based on preoperative endometrial samples and surgical specimens was fair (Kappa: 0.40; p < 0.001). However, the agreement was very significant for tumor type and grade, in which a higher concordance occurred at a higher grade. The percentage of patients with lymph nodes affected was 19.2%. Although most patients presenting with disease remission or cure were in the early stages (90.5%), there were no significant differences between those patients who had a misdiagnosis (11/16; 68.8%) and those who had a correct diagnosis (25/33; 75.8%) based on preoperative endometrial sampling (p = 0.605). Our findings corroborate the literature and confirm the under staging of preoperative endometrial samples based on histopathological assessment, especially for lower grade endometrial tumors. We suggest that the preoperative diagnosis should be complemented with other methods to better plan the surgical management strategy.
Highlights
Endometrial cancer is the second most common gynecological malignancy and the fourth most common malignancy in women
The present study aimed to evaluate the agreement between the histopathological diagnoses of preoperative endometrial samples and surgical specimens and to correlate it with the impact on surgical management and survival of patients with endometrial adenocarcinomas from our university hospital
Our findings showed that the agreement between the histopathological diagnoses based on the preoperative endometrial samples and those based on the surgical specimens is fair, and the vast majority of samples that were misdiagnosed had a lower grade classification based on preoperative endometrial sampling
Summary
Endometrial cancer is the second most common gynecological malignancy and the fourth most common malignancy in women. It represents 7% of cancers in women and the 6th most common cause of death by cancer in women. The samples obtained during hysterectomy and bilateral adnexectomy with pelvic and para-aortic lymph node dissections are necessary, and the involvement of tumor grading from intraoperative specimens is a key point.[5] the initial diagnosis is established by the histopathological analysis of endometrial biopsies.[6] The histological subtype and the grade of endometrial cancer are key factors related to the probability of disease spread and recurrence.[7,8,9,10]
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callMore From: Revista Brasileira de Ginecologia e Obstetrícia / RBGO Gynecology and Obstetrics
Disclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
