Diagnostic Accuracy of MRI for Detecting Cervical Invasion in Patients with Endometrial Carcinoma: A Meta-Analysis

Bi, Qiu; Bi, Guoli; Wang, Junna; Zhang, Jie; Li, Hongliang; Gong, Xue; Ren, Lixiang; Wu, Kunhua

doi:10.7150/jca.52797

Cited by 14 publications

(8 citation statements)

References 53 publications

(145 reference statements)

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“…The vast majority of trials report similar results, with sensitivity and specificity ranging between 75% and 84% for transvaginal US and between 82% and 90% for MRI (for diagnosing deep myometrial invasion). The sensitivity and specificity for cervical stromal invasion ranges between 69% and 82% and between 93% and 96%, both for transvaginal US and MRI ( Christensen et al , 2016 ; Pineda et al , 2016 ; Rodriguez-Trujillo et al , 2016 ; Guo et al , 2017 ; Lin et al , 2017 ; Masroor et al , 2018 ; Yildirim et al , 2018 ; Alcazar et al , 2019 ; Gil et al , 2019 ; Goel et al , 2019 ; Sanchez et al , 2019 ; Bi et al , 2020 ; Capozzi et al , 2021 ; Chen et al , 2021 ; Cubo-Abert et al , 2021 ; Gaston et al , 2021 ; Jónsdóttir et al , 2021 ; Nagar et al , 2021 ; Sobocan et al , 2021 ; Tong et al , 2021 ; Wang et al , 2021 ; Yang et al , 2021 ; Bi et al , 2021a , b ; Costas et al , 2022 ).…”

Section: Resultsmentioning

confidence: 99%

ESGO/ESHRE/ESGE Guidelines for the fertility-sparing treatment of patients with endometrial carcinoma,

Rodolakis

Scambia

Acién

et al. 2022

Human Reproduction Open

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STUDY QUESTION How should fertility-sparing treatment of patients with endometrial carcinoma be performed? SUMMARY ANSWER Forty-eight recommendations were formulated on fertility-sparing treatment of patients with endometrial carcinoma. WHAT IS KNOWN ALREADY The standard surgical treatment of endometrial carcinoma consisting of total hysterectomy with bilateral salpingo-oophorectomy drastically affects the quality of life of patients and creates a challenge for clinicians. Recent evidence-based guidelines of the European Society of Gynaecological Oncology (ESGO), the European SocieTy for Radiotherapy & Oncology (ESTRO) and the European Society of Pathology (ESP) provide comprehensive guidelines on all relevant issues of diagnosis and treatment in endometrial carcinoma in a multidisciplinary setting. While addressing also work-up for fertility preservation treatments and the management and follow-up for fertility preservation, it was considered relevant to further extend the guidance on fertility-sparing treatment. STUDY DESIGN, SIZE, DURATION A collaboration was set up between the ESGO, the European Society of Human Reproduction and Embryology (ESHRE) and the European Society for Gynaecological Endoscopy (ESGE), aiming to develop clinically relevant and evidence-based guidelines focusing on key aspects of fertility-sparing treatment in order to improve the quality of care for women with endometrial carcinoma across Europe and worldwide. PARTICIPANTS/MATERIALS, SETTING, METHODS ESGO/ESHRE/ESGE nominated an international multidisciplinary development group consisting of practising clinicians and researchers who have demonstrated leadership and expertise in the care and research of endometrial carcinoma (11 experts across Europe). To ensure that the guidelines are evidence-based, the literature published since 2016, identified from a systematic search was reviewed and critically appraised. In the absence of any clear scientific evidence, judgement was based on the professional experience and consensus of the development group. The guidelines are thus based on the best available evidence and expert agreement. Prior to publication, the guidelines were reviewed by 95 independent international practitioners in cancer care delivery and patient representatives. MAIN RESULTS AND THE ROLE OF CHANCE The multidisciplinary development group formulated 48 recommendations in four sections; patient selection, tumour clinicopathological characteristics, treatment and special issues. LIMITATIONS, REASONS FOR CAUTION Of the 48 recommendations, none could be based on level I evidence and only 16 could be based on level II evidence, implicating that 66% of the recommendations are supported only by observational data, professional experience and consensus of the development group. WIDER IMPLICATIONS OF THE FINDINGS These recommendations provide guidance to professionals caring for women with endometrial carcinoma, including but not limited to professionals in the field of gynaecological oncology, onco-fertility, reproductive surgery, endoscopy, conservative surgery and histopathology, and will help towards a holistic and multidisciplinary approach for this challenging clinical scenario. STUDY FUNDING/COMPETING INTEREST(S) All costs relating to the development process were covered from ESGO, ESHRE and ESGE funds. There was no external funding of the development process or manuscript production. G.S. has reported grants from MSD Italia S.r.l., advisory boards for Storz, Bayer, Astrazeneca, Metronic, TESARO Bio Italy S.r.l and Johnson & Johnson, and honoraria for lectures from Clovis Oncology Italy S.r.l. M.G. has reported advisory boards for Gedeon Richter and Merck. The other authors have reported no conflicts of interest. DISCLAIMER This document represents the views of ESHRE, ESGO and ESGE which are the result of consensus between the relevant stakeholders and where relevant based on the scientific evidence available at the time of preparation. The recommendations should be used for informational and educational purposes. They should not be interpreted as setting a standard of care, or be deemed inclusive of all proper methods of care nor exclusive of other methods of care reasonably directed to obtaining the same results. They do not replace the need for application of clinical judgement to each individual presentation, nor variations based on locality and facility type.

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Section: Resultsmentioning

confidence: 99%

ESGO/ESHRE/ESGE Guidelines for the fertility-sparing treatment of patients with endometrial carcinoma,

Rodolakis

Scambia

Acién

et al. 2022

Human Reproduction Open

View full text Add to dashboard Cite

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“…The vast majority of trials report similar results, with sensitivity and specificity ranging between 75% and 84% for transvaginal ultrasound and between 82% and 90% for MRI (for diagnosing deep myometrial invasion). The sensitivity and specificity for cervical stromal invasion ranges between 69% and 82% and between 93% and 96%, both for transvaginal ultrasound and MRI ( Alcazar et al, 2019 ; Bi et al, 2021a ; Bi et al, 2021b ; Bi et al, 2020 ; Capozzi et al, 2021 ; Chen et al, 2021 ; Christensen et al, 2016 ; Costas et al, 2022 ; Cubo-Abert et al, 2021 ; Gaston et al, 2022 ; Gil et al, 2019 ; Goel et al, 2019 ; Guo et al, 2017 ; Jonsdottir et al, 2021 ; Lin et al, 2017 ; Masroor et al, 2018 ; Nagar et al, 2021 ; Pineda et al, 2016 ; Rodriguez- Trujillo et al, 2016 ; Sanchez et al, 2019 ; Sobocan et al, 2021 ; Tong et al, 2021 ; Wang et al, 2021 ; Yang et al, 2021 ; Yildirim et al, 2018 ).…”

Section: Resultsmentioning

confidence: 99%

ESGO/ESHRE/ESGE Guidelines for the fertility-sparing treatment of patients with endometrial carcinoma

Rodolakis¹,

Scambia²,

Acién³

et al. 2023

Facts Views Vis ObGyn

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Background: The standard surgical treatment of endometrial carcinoma (EC) consisting of total hysterectomy with bilateral salpingo-oophorectomy drastically affects the quality of life of patients and creates a challenge for clinicians. Recent evidence-based guidelines of the European Society of Gynaecological Oncology (ESGO), the European SocieTy for Radiotherapy & Oncology (ESTRO) and the European Society of Pathology (ESP) provide comprehensive guidelines on all relevant issues of diagnosis and treatment in EC in a multidisciplinary setting. While also addressing work-up for fertility preservation treatments and the management and follow-up for fertility preservation, it was considered relevant to further extend the guidance on fertility sparing treatment. Objectives: To define recommendations for fertility-sparing treatment of patients with endometrial carcinoma. Materials and Methods: ESGO/ESHRE/ESGE nominated an international multidisciplinary development group consisting of practicing clinicians and researchers who have demonstrated leadership and expertise in the care and research of EC (11 experts across Europe). To ensure that the guidelines are evidence-based, the literature published since 2016, identified from a systematic search was reviewed and critically appraised. In the absence of any clear scientific evidence, judgment was based on the professional experience and consensus of the development group. The guidelines are thus based on the best available evidence and expert agreement. Prior to publication, the guidelines were reviewed by 95 independent international practitioners in cancer care delivery and patient representatives. Results: The multidisciplinary development group formulated 48 recommendations for fertility-sparing treatment of patients with endometrial carcinoma in four sections: patient selection, tumour clinicopathological characteristics, treatment and special issues. Conclusions: These recommendations provide guidance to professionals caring for women with endometrial carcinoma, including but not limited to professionals in the field of gynaecological oncology, onco-fertility, reproductive surgery, endoscopy, conservative surgery, and histopathology, and will help towards a holistic and multidisciplinary approach for this challenging clinical scenario. What is new? A collaboration was set up between the ESGO, ESHRE and ESGE, aiming to develop clinically relevant and evidence-based guidelines focusing on key aspects of fertility-sparing treatment in order to improve the quality of care for women with endometrial carcinoma across Europe and worldwide.

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“…For patients with suspected or gross cervical involvement (endometrioid histologies), cervical biopsy or pelvic MRI should be performed if not done previously (see "Additional Workup," page 183). 159,160,170,171 If negative, patients are assumed to have disease that is limited to the uterus and are treated as previously described, although a radical hysterectomy may be performed when necessary to obtain negative margins. Distinguishing primary cervical carcinoma from stage II endometrial carcinoma may be difficult.…”

Section: Suspected or Gross Cervical Involvementmentioning

confidence: 99%

Uterine Neoplasms, Version 1.2023, NCCN Clinical Practice Guidelines in Oncology

Abu‐Rustum

Yashar

Arend

et al. 2023

Journal of the National Comprehensive Cancer Network

177

110

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Adenocarcinoma of the endometrium (also known as endometrial cancer, or more broadly as uterine cancer or carcinoma of the uterine corpus) is the most common malignancy of the female genital tract in the United States. It is estimated that 65,950 new uterine cancer cases will have occurred in 2022, with 12,550 deaths resulting from the disease. Endometrial carcinoma includes pure endometrioid cancer and carcinomas with high-risk endometrial histology (including uterine serous carcinoma, clear cell carcinoma, carcinosarcoma [also known as malignant mixed Müllerian tumor], and undifferentiated/dedifferentiated carcinoma). Stromal or mesenchymal sarcomas are uncommon subtypes accounting for approximately 3% of all uterine cancers. This selection from the NCCN Guidelines for Uterine Neoplasms focuses on the diagnosis, staging, and management of pure endometrioid carcinoma. The complete version of the NCCN Guidelines for Uterine Neoplasms is available online at NCCN.org.

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Diagnostic Accuracy of MRI for Detecting Cervical Invasion in Patients with Endometrial Carcinoma: A Meta-Analysis

Cited by 14 publications

References 53 publications

ESGO/ESHRE/ESGE Guidelines for the fertility-sparing treatment of patients with endometrial carcinoma,

ESGO/ESHRE/ESGE Guidelines for the fertility-sparing treatment of patients with endometrial carcinoma,

ESGO/ESHRE/ESGE Guidelines for the fertility-sparing treatment of patients with endometrial carcinoma

Uterine Neoplasms, Version 1.2023, NCCN Clinical Practice Guidelines in Oncology

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