Preoperative Histopathological Grading and Clinical Staging Versus Surgico-Pathological Grading and Surgical Staging in Endometrial Carcinoma Patients: A Single Centre Retrospective Study

Soobhug Rishikesh Singh

Authors

Soobhug Rishikesh Singh

Keywords:

endometrioid adenocarcinoma, serous carcinoma, clear cell carcinoma, histological grade and staging

Abstract

Objectives: To compare the accuracy of tumor cell type, tumor grade, and staging pre - and postoperatively in patients with endometrial carcinoma. Materials and Methods: A retrospective analysis of 81 patients who were diagnosed with endometrial carcinoma and underwent hysterectomy at the 1st Affiliated Hospital of Chongqing Medical University from January 2015 to December 2016. Results: Endometrioid adenocarcinoma was the most common histological subtype with an agreement of 75.3% (61/81) on final pathology. The overall concordance rate between pre- and postoperative histological grade was 65.4% (53/81). 25.9% (21/81) patients had been upgraded while 8.6% (7/81) had been downgraded. The accuracy of clinical and surgical staging was 64.2% (52/81) with 22.2% (18/81) patients had been upstaged and 13.6% (11/81) down-staged. Conclusion: Tumor histology and grade, as well as the clinical staging, are only moderate predictors of the final surgical pathological outcome and surgical staging. The highly aggressive serous and clear cell carcinomas have been missed on endometrial samplings. Preoperative grade 1 and clinical stage II tumors had the lowest agreement when compared postoperatively. Cautious planning and patient counseling must be required regarding the surgical approach to endometrial cancer.

Downloads

How to Cite

Preoperative Histopathological Grading and Clinical Staging Versus Surgico-Pathological Grading and Surgical Staging in Endometrial Carcinoma Patients: A Single Centre Retrospective Study. (2018). Global Journal of Medical Research, 18(E1), 19-28. https://medicalresearchjournal.org/index.php/GJMR/article/view/1459

Download Citation

References

Jacques Ferlay, Isabelle Soerjomataram, Rajesh Dikshit, Sultan Eser, Colin Mathers, Marise Rebelo, Donald Parkin, David Forman, Freddie Bray (2012) Cancer incidence and mortality worldwide: Sources, methods and major patterns in GLOBOCAN 2012. 136(5).

X Jiang, H Tang, T Chen (2018) Epidemiology of gynecologic cancers in China. 29(1), e7.

A Ali (2013) Risk factors for endometrial cancer. 78(5), 448-459.

H Yang, N Wentzensen, B Trabert, G Gierach, A Felix, M Gunter (2013) Endometrial cancer risk factors by 2 main histologic subtypes: the NIH-AARP Diet and Health Study. 177(2), 142-151.

F Amant, P Moerman, P Neven, D Timmerman, E Van Limbergen, I Vergote (2005) Endometrial cancer. 366, 491-505.

Ncm Visser, C Reijnen, L Massuger, I Nagtegaal, J Bulten, Jma Pijnenborg (2017) Accuracy of Endometrial Sampling in Endometrial Carcinoma: A Systematic Review and Meta-analysis. 130(4), 803-813.

Blaise Clarke, C Gilks (2010) Endometrial carcinoma: controversies in histopathological assessment of grade and tumour cell type. 63(5), 410-415.

Ulla-Maija Haltia, Ralf Bützow, Arto Leminen, Mikko Loukovaara (2014) FIGO 1988 versus 2009 staging for endometrial carcinoma: a comparative study on prediction of survival and stage distribution according to histologic subtype. 25(1), 30.

C Goudge, S Bernhard, N Cloven, P Morris (2004) The impact of complete surgical staging on adjuvant treatment decisions in endometrial cancer. 93(2), 536-539.

W Creasman, C Morrow, B Bundy, H Homesley, J Graham, P Heller (1987) Surgical pathologic spread patterns of endometrial cancer. A Gynecologic Oncology Group Study. 60(8), 2035-2041.

N Abu-Rustum, Q Zhou, A Iasonos, K Alektiar, M Leitao, Jr Chi, D (2011) The revised 2009 FIGO staging system for endometrial cancer: should the 1988 FIGO stages IA and IB be altered? International journal of gynecological cancer. 21(3), 511-516.

Xipeng Wang, Ziying Huang, Wen Di, Qide Lin (2005) Comparison of D&C and hysterectomy pathologic findings in endometrial cancer patients. 272(2), 136-141.

Nakarin Sirisabya, Tarinee Manchana, Pongkasem Worasethsin, Nipon Khemapech, Ruangsak Lertkhachonsuk, Tul Sittisomwong, Apichai Vasuratna, Wichai Termrungruanglert, Damrong Tresukosol (2009) Is Complete Surgical Staging Necessary in Clinically Early-Stage Endometrial Carcinoma?. 19(6), 1057-1061.

Frédéric Amant, Mansoor Mirza, Martin Koskas, Carien Creutzberg (2015) Cancer of the corpus uteri. 131(S2), 96-104.

M Momeni, V Kolev, J Cardenas-Goicoechea, J Getrajdman, D Fishman, L Chuang (2013) Does the type of surgery for early-stage endometrial cancer affect the rate of reported lymphovascular space invasion in final pathology specimens?. 208(1), 71-e71.

Janiel Cragun, Laura Havrilesky, Brian Calingaert, Ingrid Synan, Angeles Secord, John Soper, Daniel Clarke-Pearson, Andrew Berchuck (2005) Retrospective Analysis of Selective Lymphadenectomy in Apparent Early-Stage Endometrial Cancer. 23(16), 3668-3675.

Taymaa May, Melina Shoni, Allison Vitonis, Charles Quick, Whitfield Growdon, Michael Muto (2013) The Role of Para-Aortic Lymphadenectomy in the Surgical Staging of Women with Intermediate and High-Risk Endometrial Adenocarcinomas. 2013, 1-7.

B Rungruang, A Olawaiye (2012) Comprehensive Surgical Staging for Endometrial Cancer. 5(1), 28-34.

F Falcone, G Balbi, Di Martino, L Grauso, F Salzillo, M Messalli, E (2014) Surgical management of early endometrial cancer: an update and proposal of a therapeutic algorithm. 20, 1298-1313.

R Jones, Q Chen, R Best, B Libby, E Crandley, T Showalter (2014) Dosimetric feasibility of stereotactic body radiation therapy as an alternative to brachytherapy for definitive treatment of medically inoperable early stage endometrial cancer. 9, 164.

T Kirby, C Leath, L Kilgore (2006) Surgical staging in endometrial cancer. 20(1), 3-4.

W Lee, F Lee, W Su, K Tsui, C Kuo, S Hsieh (2012) Hormone therapy for younger patients with endometrial cancer. 51(4), 495-505.

G Shukla, S Beriwal, T Krivak, J Kelley, P Sukumvanich, R Edwards (2011) Preoperative high dose rate brachytherapy for clinical stage II endometrial carcinoma. 3(2), 70-73.

Rosemarie Schmandt, David Iglesias, Ngai Co, Karen Lu (2011) Understanding obesity and endometrial cancer risk: opportunities for prevention. 205(6), 518-525.

K Lindemann, L Vatten, M Ellstrom-Engh, A Eskild (2008) Body mass, diabetes and smoking, and endometrial cancer risk: a follow-up study. 98(9), 1582-1585.

K Matsuo, A Ramzan, M Gualtieri, P Mhawech-Fauceglia, H Machida, A Moeini (2015) Prediction of concurrent endometrial carcinoma in women with endometrial hyperplasia. 139(2), 261-267.

Carla Bartosch, José Manuel Lopes, Esther Oliva (2011) Endometrial Carcinomas. 18(6), 415-437.

M Cote, T Alhajj, J Ruterbusch, L Bernstein, L Brinton, W Blot (2015) Risk factors for endometrial cancer in black and white women: a pooled analysis from the Epidemiology of Endometrial Cancer Consortium (E2C2). 26(2), 287-296.

H Arem, M Irwin (2005) Obesity and endometrial cancer survival: a systematic review. 37(5), 634-639.

Lingeng Lu, Harvey Risch, Melinda Irwin, Susan Mayne, Brenda Cartmel, Peter Schwartz, Thomas Rutherford, Herbert Yu (2011) Long‐term overweight and weight gain in early adulthood in association with risk of endometrial cancer. 129(5), 1237-1243.

A Mills, S Liou, J Ford, J Berek, R Pai, T Longacre (2014) Lynch syndrome screening should be considered for all patients with newly diagnosed endometrial cancer. 38(11), 1501-1509.

J Luo, S Beresford, C Chen, R Chlebowski, L Garcia, L Kuller (2014) Association between diabetes, diabetes treatment and risk of developing endometrial cancer. 111(7), 1432-1439.

Y Cakiroglu, E Doger, Yildirim Kopuk, S Ozcan, C Nalbant, B Corakci, A (2014) Prediction of tumor grade and stage in endometrial carcinoma by preoperative assessment of sonographic endometrial thickness: Is it possible?. 11(4), 211-214.

A Talhouk, J Mcalpine (2016) New classification of endometrial cancers: the development and potential applications of genomic-based classification in research and clinical care. 3(1), 14.

B Goksedef, O Akbayir, A Corbacioglu, H Guraslan, F Sencan, O Erol (2012) Comparison of preoperative endometrial biopsy grade and final pathologic diagnosis in patients with endometrioid endometrial cancer. 13(2), 106-110.

T Cowles, Magrina Jf, Masterson Bj, Capen Cv Comparison of Clinical and Surgical.