Accuracy of preoperative curettage in determining tumor type and grade in endometrial cancer

To compare the accuracy of tumor grade and type in endometrial cancer between samples from preoperative curettage and postoperative hysterectomy specimens.

From January 2002 to June 2006, 98 women diagnosed with endometrial cancer and treated in the Department of Obstetrics and Gynecology, Siriraj Hospital were included The comparisons of tumor types and grades were performed on both preoperative endometrial curettage and hysterectomy specimens; the relationships between the concordance rate and accuracy of types and grades were analyzed.

Endometrial samples and the subsequent hysterectomy specimens from 98 patients were studied After exclusion of benign endometrial tissue sampling and no residual tumor in hysterectomy specimen and preoperative diagnosis from endometrial biopsy, 86 patients were analyzed The overall tumor type accuracy was 93.0% for endometrioid type. The comparative FIGO grades were analyzed between preoperative endometrial samplings and hysterectomy specimens. Accuracy was 74.0% for grade 1, 75.3% for grade 2 and 90.4% for grade 3. The accuracy for grade 3 tumors was significantly higher than for grade 1.

The authors should be careful in planning patient management based on the initial histological findings. It is important for clinicians to be aware that endometrial adenocarcinoma may show focal variation in tumor grade and to be aware of the limitation of examination of small tissue samples.