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Accuracy of endometrial sampling in the diagnosis of endometrial cancer: a multicenter retrospective analysis of the
Zaher Alwafai1,2, Maximilian Heinz Beck3,4,5, Sepideh Fazeli2,6
1Department of Gynecology and Obstetrics, University of Greifswald, Greifswald, Germany.
BMC Cancer
|March 26, 2024
Summary
Preoperative endometrial cancer evaluation has limited accuracy, particularly for non-endometrioid subtypes and high-grade tumors. Careful consideration is needed for treatment planning due to potential histologic discrepancies.
Area of Science:
- Gynecologic Oncology
- Pathology
- Cancer Research
Background:
- Accurate preoperative risk stratification is crucial for endometrial cancer treatment.
- Inconsistencies between pre- and postoperative tumor histology are a known issue.
- Identifying risk factors for inaccurate preoperative diagnosis is essential.
Purpose of the Study:
- To identify risk factors associated with inaccurate histologic diagnosis in preoperative endometrial evaluations.
- To assess the accuracy of preoperative histologic subtype and tumor grading.
- To inform treatment planning for endometrial cancer.
Main Methods:
- Retrospective analysis of 375 primary endometrial cancer patients.
- Evaluation of histological assessments from curettage and hysterectomy specimens.
- Comparison of preoperative and postoperative histological findings.
Main Results:
- Preoperative histologic subtype confirmed in 89.5% of cases; tumor grading in 75.2%.
- Higher rates of histologic subtype variation (36.84%) observed in non-endometrioid carcinomas.
- Non-endometrioid histology and high-grade carcinomas predicted diverging subtypes; intermediate/high grading predicted diverging tumor grading.
Conclusions:
- Preoperative endometrial sampling accuracy is limited, especially for non-endometrioid histology and high-grade tumors.
- These limitations must be considered during endometrial cancer treatment planning.
- Improved preoperative assessment strategies may enhance treatment efficacy.
