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Histopathology Discrepancy of Preoperative Endometrial Sampling and Final Specimen: How Does This Influence Selective
Bradley R Corr1, Aakriti Carrubba, Jeanelle Sheeder
1Department of Obstetrics & Gynecology, University of Colorado Anschutz Medical Campus, Aurora, CO.
Summary
Histopathology discrepancies in endometrial cancer are common (20%), but rarely alter lymph node dissection decisions (0.7%). Tumor size and invasion depth are more critical for guiding treatment.
Area of Science:
- Gynecologic Oncology
- Surgical Pathology
- Cancer Staging
Background:
- Preoperative endometrial sampling guides lymph node (LN) dissection in endometrial cancer.
- Discrepancies between initial sampling and final pathology are common.
- The impact of these discrepancies on treatment decisions requires investigation.
Purpose of the Study:
- To determine if histopathology discrepancies affect adjuvant treatment or patient outcomes.
- To assess the frequency of discrepancies that would alter lymph node dissection decisions.
Main Methods:
- Retrospective analysis of 308 endometrial cancer patients (2010-2014).
- Evaluation of preoperative endometrial sampling versus final surgical specimen histopathology.
- Analysis of criteria for omitting lymph node dissection.
Main Results:
- Histopathology discrepancy occurred in 20.8% of cases.
- Only 0.7% of discrepancies would have altered the decision for lymph node dissection based on defined criteria.
- Myometrial invasion and tumor size were more consistently influential in LN dissection decisions.
Conclusions:
- While preoperative and final histopathology often differ, these discrepancies infrequently change lymph node dissection strategies.
- Tumor characteristics like myometrial invasion and size appear more critical than histology for guiding lymph node dissection in endometrial cancer.
