Assessment of Preoperative Endometrial Histopathological Sampling as a Predictor of Final Surgical Pathology in Endometrial Cancer
Abstract Objective To evaluate the agreement between the histopathological diagnoses of preoperative endometrial samples and surgical specimens and correlate the agreement between the diagnoses with the impact on surgical management and the survival of patients with endometrial adenocarcinomas. Methods Sixty-two patients treated for endometrial cancer at a university hospital from 2002 to 2011 were retrospectively evaluated. The histopathological findings of preoperative endometrial samples and of surgical specimens were analyzed. The patients were subjected to hysterectomy as well as adjuvant treatment, if necessary, and clinical follow-up, according to the institutional protocol. Lesions were classified as endometrioid tumor (type 1) grades 1, 2, or 3 or non-endometrioid carcinoma (type 2). Results The agreement between the histopathological diagnoses based on preoperative endometrial samples and surgical specimens was fair (Kappa: 0.40; p < 0.001). However, the agreement was very significant for tumor type and grade, in which a higher concordance occurred at a higher grade. The percentage of patients with lymph nodes affected was 19.2%;. Although most patients presenting with disease remission or cure were in the early stages (90.5%;), there were no significant differences between those patients who had a misdiagnosis (11/16; 68.8%;) and those who had a correct diagnosis (25/33; 75.8%;) based on preoperative endometrial sampling (p = 0.605). Conclusion Our findings corroborate the literature and confirm the under staging of preoperative endometrial samples based on histopathological assessment, especially for lower grade endometrial tumors. We suggest that the preoperative diagnosis should be complemented with other methods to better plan the surgical management strategy.
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Federação Brasileira das Sociedades de Ginecologia e Obstetrícia
2020
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oai:scielo:S0100-720320200010006422020-12-18Assessment of Preoperative Endometrial Histopathological Sampling as a Predictor of Final Surgical Pathology in Endometrial CancerPiotto,Mario Augusto Silveira BuenoFocchi,Gustavo Rubino de AzevedoMarques,Renato MorettiTeixeira,Andressa Melina SeverinoGonçalves,Wagner JoséNicolau,Sergio Mancini cancer of the endometrium histopathological diagnosis diagnostic method endometrial cancer surgery Abstract Objective To evaluate the agreement between the histopathological diagnoses of preoperative endometrial samples and surgical specimens and correlate the agreement between the diagnoses with the impact on surgical management and the survival of patients with endometrial adenocarcinomas. Methods Sixty-two patients treated for endometrial cancer at a university hospital from 2002 to 2011 were retrospectively evaluated. The histopathological findings of preoperative endometrial samples and of surgical specimens were analyzed. The patients were subjected to hysterectomy as well as adjuvant treatment, if necessary, and clinical follow-up, according to the institutional protocol. Lesions were classified as endometrioid tumor (type 1) grades 1, 2, or 3 or non-endometrioid carcinoma (type 2). Results The agreement between the histopathological diagnoses based on preoperative endometrial samples and surgical specimens was fair (Kappa: 0.40; p < 0.001). However, the agreement was very significant for tumor type and grade, in which a higher concordance occurred at a higher grade. The percentage of patients with lymph nodes affected was 19.2%;. Although most patients presenting with disease remission or cure were in the early stages (90.5%;), there were no significant differences between those patients who had a misdiagnosis (11/16; 68.8%;) and those who had a correct diagnosis (25/33; 75.8%;) based on preoperative endometrial sampling (p = 0.605). Conclusion Our findings corroborate the literature and confirm the under staging of preoperative endometrial samples based on histopathological assessment, especially for lower grade endometrial tumors. We suggest that the preoperative diagnosis should be complemented with other methods to better plan the surgical management strategy.info:eu-repo/semantics/openAccessFederação Brasileira das Sociedades de Ginecologia e ObstetríciaRevista Brasileira de Ginecologia e Obstetrícia v.42 n.10 20202020-10-01info:eu-repo/semantics/articletext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S0100-72032020001000642en10.1055/s-0040-1713802 |
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Piotto,Mario Augusto Silveira Bueno Focchi,Gustavo Rubino de Azevedo Marques,Renato Moretti Teixeira,Andressa Melina Severino Gonçalves,Wagner José Nicolau,Sergio Mancini |
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Piotto,Mario Augusto Silveira Bueno Focchi,Gustavo Rubino de Azevedo Marques,Renato Moretti Teixeira,Andressa Melina Severino Gonçalves,Wagner José Nicolau,Sergio Mancini Assessment of Preoperative Endometrial Histopathological Sampling as a Predictor of Final Surgical Pathology in Endometrial Cancer |
author_facet |
Piotto,Mario Augusto Silveira Bueno Focchi,Gustavo Rubino de Azevedo Marques,Renato Moretti Teixeira,Andressa Melina Severino Gonçalves,Wagner José Nicolau,Sergio Mancini |
author_sort |
Piotto,Mario Augusto Silveira Bueno |
title |
Assessment of Preoperative Endometrial Histopathological Sampling as a Predictor of Final Surgical Pathology in Endometrial Cancer |
title_short |
Assessment of Preoperative Endometrial Histopathological Sampling as a Predictor of Final Surgical Pathology in Endometrial Cancer |
title_full |
Assessment of Preoperative Endometrial Histopathological Sampling as a Predictor of Final Surgical Pathology in Endometrial Cancer |
title_fullStr |
Assessment of Preoperative Endometrial Histopathological Sampling as a Predictor of Final Surgical Pathology in Endometrial Cancer |
title_full_unstemmed |
Assessment of Preoperative Endometrial Histopathological Sampling as a Predictor of Final Surgical Pathology in Endometrial Cancer |
title_sort |
assessment of preoperative endometrial histopathological sampling as a predictor of final surgical pathology in endometrial cancer |
description |
Abstract Objective To evaluate the agreement between the histopathological diagnoses of preoperative endometrial samples and surgical specimens and correlate the agreement between the diagnoses with the impact on surgical management and the survival of patients with endometrial adenocarcinomas. Methods Sixty-two patients treated for endometrial cancer at a university hospital from 2002 to 2011 were retrospectively evaluated. The histopathological findings of preoperative endometrial samples and of surgical specimens were analyzed. The patients were subjected to hysterectomy as well as adjuvant treatment, if necessary, and clinical follow-up, according to the institutional protocol. Lesions were classified as endometrioid tumor (type 1) grades 1, 2, or 3 or non-endometrioid carcinoma (type 2). Results The agreement between the histopathological diagnoses based on preoperative endometrial samples and surgical specimens was fair (Kappa: 0.40; p < 0.001). However, the agreement was very significant for tumor type and grade, in which a higher concordance occurred at a higher grade. The percentage of patients with lymph nodes affected was 19.2%;. Although most patients presenting with disease remission or cure were in the early stages (90.5%;), there were no significant differences between those patients who had a misdiagnosis (11/16; 68.8%;) and those who had a correct diagnosis (25/33; 75.8%;) based on preoperative endometrial sampling (p = 0.605). Conclusion Our findings corroborate the literature and confirm the under staging of preoperative endometrial samples based on histopathological assessment, especially for lower grade endometrial tumors. We suggest that the preoperative diagnosis should be complemented with other methods to better plan the surgical management strategy. |
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Federação Brasileira das Sociedades de Ginecologia e Obstetrícia |
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2020 |
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http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0100-72032020001000642 |
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