Sonographische Bestimmung der Infiltrationstiefe beim Endometriumkarzinom

Abstract

Purpose: Myometrial invasion depth of endometrial cancer is an important prognostic factor. Preoperative assessment is decisive for appropriate surgical treatment. The aim of the study is to assess the value of transvaginal sonography (TVS) for determining the myometrial invasion depth in endometrial cancer. Material and Methods: In 214 patients with endometrial cancer (118 patients before and 96 other patients after dilatation and curettage (D&C]), the myometral invasion depth (greater than 50% or less than 50%) was measured preoperatively. The maximum endometrial height (twice the thickness) was measured sonographically. The maximum endometrial height (E) was set in relation to the anterior-posterior diameter of the uterus (U). A myometrial invasion depth of greater than 50% was assumed with E/U >0.5. An invasion which was limited to the inner half of the myometrium was represented as E/U <=0.5. The sonographic results were compared to the histopathological findings. Results: A sensitivity of 92% and a positive predictive value of 74% were obtained for invasion depths of greater than 50%. In 13% of the cases the invasion depth was overestimated while in only 3% it was underestimated. The diagnostic accuracy in both groups was equivalent: 83% for TVS before D&C and 85% for TVS after D&C. Conclusion: TVS is a valuable, non-invasive diagnostic method for patients with endometrial cancer. If TVS data are combined with results from other preoperative tests, the obtained prognostic information provides a useful basis for choosing the appropriate therapy.