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. Me...
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Federação Brasileira das Sociedades de Ginecologia e Obstetrícia
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| Series: | Revista Brasileira de Ginecologia e Obstetrícia |
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| Online Access: | http://www.scielo.br/pdf/rbgo/v42n10/1806-9339-rbgo-42-10-0643.pdf |
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| author | Mario Augusto Silveira Bueno Piotto Gustavo Rubino de Azevedo Focchi Renato Moretti Marques Andressa Melina Severino Teixeira Wagner José Gonçalves Sergio Mancini Nicolau |
| author_facet | Mario Augusto Silveira Bueno Piotto Gustavo Rubino de Azevedo Focchi Renato Moretti Marques Andressa Melina Severino Teixeira Wagner José Gonçalves Sergio Mancini Nicolau |
| author_sort | Mario Augusto Silveira Bueno Piotto |
| collection | DOAJ |
| 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. |
| first_indexed | 2024-12-22T01:19:13Z |
| format | Article |
| id | doaj.art-87ca86ea59454a15ac120410c473e9a5 |
| institution | Directory Open Access Journal |
| issn | 0100-7203 |
| language | English |
| last_indexed | 2024-12-22T01:19:13Z |
| publisher | Federação Brasileira das Sociedades de Ginecologia e Obstetrícia |
| record_format | Article |
| series | Revista Brasileira de Ginecologia e Obstetrícia |
| spelling | doaj.art-87ca86ea59454a15ac120410c473e9a52022-12-21T18:43:46ZengFederação Brasileira das Sociedades de Ginecologia e ObstetríciaRevista Brasileira de Ginecologia e Obstetrícia0100-720310.1055/s-0040-1713802Assessment of Preoperative Endometrial Histopathological Sampling as a Predictor of Final Surgical Pathology in Endometrial CancerMario Augusto Silveira Bueno PiottoGustavo Rubino de Azevedo FocchiRenato Moretti MarquesAndressa Melina Severino TeixeiraWagner José GonçalvesSergio Mancini NicolauAbstract 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.http://www.scielo.br/pdf/rbgo/v42n10/1806-9339-rbgo-42-10-0643.pdfcancer of the endometriumhistopathological diagnosisdiagnostic methodendometrial cancer surgery |
| spellingShingle | Mario Augusto Silveira Bueno Piotto Gustavo Rubino de Azevedo Focchi Renato Moretti Marques Andressa Melina Severino Teixeira Wagner José Gonçalves Sergio Mancini Nicolau Assessment of Preoperative Endometrial Histopathological Sampling as a Predictor of Final Surgical Pathology in Endometrial Cancer Revista Brasileira de Ginecologia e Obstetrícia cancer of the endometrium histopathological diagnosis diagnostic method endometrial cancer surgery |
| title | 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_short | 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 |
| topic | cancer of the endometrium histopathological diagnosis diagnostic method endometrial cancer surgery |
| url | http://www.scielo.br/pdf/rbgo/v42n10/1806-9339-rbgo-42-10-0643.pdf |
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