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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Main Authors: Piotto,Mario Augusto Silveira Bueno, Focchi,Gustavo Rubino de Azevedo, Marques,Renato Moretti, Teixeira,Andressa Melina Severino, Gonçalves,Wagner José, Nicolau,Sergio Mancini
Format: Digital revista
Language:English
Published: Federação Brasileira das Sociedades de Ginecologia e Obstetrícia 2020
Online Access:http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0100-72032020001000642
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spelling 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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language English
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author Piotto,Mario Augusto Silveira Bueno
Focchi,Gustavo Rubino de Azevedo
Marques,Renato Moretti
Teixeira,Andressa Melina Severino
Gonçalves,Wagner José
Nicolau,Sergio Mancini
spellingShingle 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.
publisher Federação Brasileira das Sociedades de Ginecologia e Obstetrícia
publishDate 2020
url http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0100-72032020001000642
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