Accuracy of intraoperative gross visual assessment of myometrial invasion in endometrial cancer
Janusz Marcickiewicz1, Karin Sundfeldt
1Institute for Clinical Sciences, Department of Obstetrics and Gynecology, Sahlgrenska Academy, University of Gothenburg, Sweden. janusz.marcickiewicz@obgyn.gu.se
Objective:
To evaluate the accuracy of gross visual assessment of myometrial invasion in endometrial carcinoma.
Design:
Prospective, descriptive study.
Setting:
University hospital.
Population:
Two hundred and fourteen consecutive patients operated between 2005 and 2008. All patients were preoperatively diagnosed with endometrial carcinoma or complex atypical hyperplasia considered by the pathologist to be at the border of highly differentiated endometrial cancer.
Methods:
Intraoperative gross visual assessment of myometrial tumor invasion (<50 or ≥50%), cervical tumor engagement and tumor diameter in millimeters were noted for all patients.
Main Outcome Measures:
The collected data were compared with final histopathology.
Results:
Intraoperative gross visual assessment of myometrial tumour invasion correlated well with final histology, with an accuracy of 87%. Agreement between gross visual assessment and final histology was reached in 91% of grade 1 tumors. Additionally, we found that 98.5% of tumors with a diameter <20mm had <50% myometrial invasion, regardless of grade.
Conclusions:
Intraoperative gross visual assessment of myometrial tumor invasion and tumor size measurements are simple, fast and inexpensive methods that may provide important information for the surgeon to decide upon the extent of staging when other more accurate methods are not at hand.
