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[Histological grade in management of carcinoma of endometrium]
P Dzvincuk1, R Pilka, M Kudela
1Gynekologicko-porodnická klinika, LF UP a FN, Olomouc.
Objective:
To correlate histological differentiation of endometrial cancer assessed from material obtained at diagnostic operation (hysteroscopy and targeted biopsy or curettage) and definitive radical surgical treatment.
Design:
A prospective multicentric study.
Setting:
Department of Obstetrics and Gynaecology, Institute of Pathology, Palacký University Medical School and University Hospital, Olomouc.
Material And Methods:
237 patients with endometrial adenocarcinoma diagnosed between 1997-2001 were enrolled into this study. Histopathologic differentiation of tumoral tissue obtained at diagnostic and definitive radical operation were compared.
Results:
Discrepancies in histopathologic differentiation of tumoral tissue obtained at diagnostic and definitive operation were found to be present in 42.2% of grade 1 (G1), 34.8% of grade 2 (G2), and 25.6% of grade 3 (G3) samples. When divided into subgroups, we observed discrepancies in 37.1% of G1, 31.5% of G2, and 26.7% of G3 tumors diagnosed at hysteroscopy and targeted biopsy. In patients with D&C the discrepancies were present in 53.1% of G1, 41.4% of G2, and 23.1% of G3 tumors.
Conclusions:
Low correlation between histopathologic differentiation of tumoral tissue obtained at diagnostic and definitive surgery supports the necessity of surgical staging in all patients with endometrial cancer. Primary radiotherapy should be reserved only for patients, in which the surgery is contraindicated.
