Diagnostic performance of intraoperative assessment in grade 2 endometrioid endometrial carcinoma

World Journal of Surgical Oncology

Antonio Bandala-Jacques¹  Diddier Prada²  Rosa A. Salcedo-Hernández³  Salim Abraham Barquet-Muñoz³  Arely Gonzalez-Valdés³  Delia Pérez-Montiel⁴  Aarón González-Enciso⁵  David Cantú-de-León⁶ 

[1] Biomedical Cancer Research Unit, Instituto Nacional de Cancerología, Mexico City, Mexico;Biomedical Investigations Institute, Universidad Nacional Autonóma de México, Mexico City, Mexico;Biomedical Cancer Research Unit, Instituto Nacional de Cancerología, Mexico City, Mexico;Department of Biomedical Informatics, Faculty of Medicine, Universidad Nacional Autónoma de México, Mexico City, Mexico;Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York City, USA;Department of Gynecology, Instituto Nacional de Cancerología, Mexico City, Mexico;Department of Pathology, Instituto Nacional de Cancerología, Mexico City, Mexico;Department of Surgery, Instituto Nacional de Cancerología, Mexico City, Mexico;Instituto Nacional de Cancerología, Mexico City, Mexico;

关键词: Endometrial cancer;    Endometrioid adenocarcinoma;    Surgical diagnostic technique;    Frozen sections;    Lymphadenectomy;    Myometrial invasion;   

DOI  :  10.1186/s12957-020-02056-7

来源: Springer

【 摘 要 】

BackgroundEndometrial carcinoma is the most common gynecologic malignancy in developed countries. Grade 2 carcinoma is associated with pelvic lymph-node metastasis, depending on selected risk factors. Intraoperative assessment (IOA) can identify patients at risk for lymph node metastasis who should undergo staging surgery. Our objective was to establish the diagnostic precision of IOA in determining the need for surgical staging in grade 2 endometrioid endometrial carcinoma.MethodsTwo hundred twenty-two patients underwent IOA. Results were compared to the final pathology report. The accuracy of the IOA parameters was calculated. Variables were evaluated in patients with positive versus negative IOA. Overall and disease-free survivals were calculated according to IOA, lymphadenectomy, and nodal metastasis.ResultsIOA was positive in 80 patients. It showed an accuracy of 76.13% when compared with the postoperative assessment. The best individual parameter was myometrial invasion. Nodal metastasis was observed in 16 patients in the positive IOA group and 7 patients in the negative group. Patients with lymph node metastasis had a 5-year overall survival rate of 80.9%, whereas patients without metastasis had a 5-year overall survival rate of 97.9%.ConclusionsIOA is an adequate tool to identify high-risk patients in grade 2 endometrial carcinoma. Myometrial invasion is the individual parameter that yields the highest diagnostic precision.

【 授权许可】

CC BY