Comparison of D&amp;C and office endometrial biopsy in predicting final histopathologic grade in endometrial cancer

Larson, Dale M.; Johnson, Kenita K.; Broste, Steven K.; Krawisz, Bruce R.; Kresl, John J.

doi:10.1016/0029-7844(95)00105-z

Cited by 117 publications

(54 citation statements)

References 8 publications

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“…There is also a significant inter-and intraobserver discrepancy of up to 40% in the differentiation between atypical endometrial hyperplasia and well-differentiated adenocarcinoma [47,48] and in the determination of the histologic grade of tumor [49]. It is reported that the grade of tumor may change in 25% of cases and be upgraded in 10% of cases of endometrial cancer after hysterectomy [40,50]. In addition, studies have shown that the endometrioid histology may change to other histologic types or other primary cancers after a hysterectomy [51][52][53].…”

Section: Pretreatment Evaluationmentioning

confidence: 99%

“…It is very difficult to differentiate grade 1 adenocarcinoma from atypical complex hyperplasia [39] and to accuratelydeterminethehistologic grade of tumor using the small tissue samples that are obtained by office endometrial biopsy [40]. The histologic grade of tumor determined by office endometrial biopsy was upgraded after hysterectomy in 26% of cases, whereas the grade determined by DCBx was upgraded in 10% of cases after hysterectomy [40]. DCBx can also provide a therapeutic benefit by removing all, or at least most, of the cancer tissues in the endometrial cavity, whereas office endometrial biopsy serves a diagnostic role only.…”

Section: Pretreatment Evaluationmentioning

confidence: 99%

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Progestins in the Fertility-Sparing Treatment and Retreatment of Patients With Primary and Recurrent Endometrial Cancer

Nam

2015

The Oncologist

109

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Endometrial cancer is the most common gynecologic cancer in developed countries. Approximately 3%-14% of endometrial cancers are diagnosed in young women under 40 who want to preserve their fertility. The incidence of endometrial cancer in this age group is increasing, for which fertility-sparing therapy is increasingly used because it is one of the most important quality of life issues in these women. Progestin therapy is the most common type of fertility-sparing therapy. In this review, the most up-to-date findings regarding fertility-sparing progestin therapy for young women with primary and recurrent endometrial cancer is addressed in terms of diagnosis, treatment, follow-up, and oncologic and reproductive outcomes. Fertility-sparing progestin therapy is highly effective in selected young women with primary and recurrent endometrial cancer. The selection of appropriate patients through comprehensive pretreatment evaluation is of paramount importance to achieve the best outcomes without compromising survival. Because of the high rate of recurrence after successful fertility-sparing therapy, close surveillance is mandatory, and prophylactic hysterectomy is the best option for patients who have completed family planning. Pregnancy outcomes are very promising with the aid of assisted reproductive technologies. Continuous daily oral medroxyprogesterone acetate and megestrol acetate are the preferred progestins for fertility-sparing therapy, but future studies should be performed to determine the optimal dose and treatment duration of these agents. The Oncologist 2015; 20:270-278 Implications for Practice: In young women with endometrial cancer, the cure rate is very high.Therefore, the efficacy of treatment should not be limited to the oncologic outcomes.The quality-of-life issue is as important as oncologic outcomes in these patients. Fertility preservation is one of the most important quality-of-life issues. Based on the results of numerous studies, fertility-sparing progestin therapy can be safely performed in endometrioid adenocarcinoma confined to the endometrium. It also can be reasonably recommended to selected women with more advanced disease and recurrent disease. However, careful follow-up is important because of the high rate of recurrence.

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Section: Pretreatment Evaluationmentioning

confidence: 99%

Section: Pretreatment Evaluationmentioning

confidence: 99%

Progestins in the Fertility-Sparing Treatment and Retreatment of Patients With Primary and Recurrent Endometrial Cancer

Nam

2015

The Oncologist

109

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“…Destarte, a nosso ver caberia indicação de curetagem em algumas situações. Quando a biópsia do endométrio mostrar hiperplasia adenomatosa, pois o carcinoma oculto pode coexistir com esse tipo de hiperplasia em cerca de 30% dos casos 23 ; da mesma forma, o achado de hiperplasia atípica à biopsia merece estudo de maior quantidade de endométrio, uma vez que a D&C tem mais acurácia do que a biópsia na avaliação do grau de diferenciação do câncer endometrial 24 . Nos casos em que há discordância entre impressão histeroscópica e biópsia endometrial, principalmente quando o diagnóstico histeroscópico sugerir lesão grave; nestas circunstâncias, a histeroscopia com ou sem biopsia sob controle visual pode ser repetida sob narcose e complementada por curetagem que possibilitará maior quantidade de endométrio para exame.…”

Section: Melki Et Alunclassified

Dilatação e Curetagem na Avaliação do Sangramento Uterino Anormal: Achados Histopatológicos e Relação Custo/Benefício

Melki¹,

Oliveira²,

Filho³

et al. 2000

Rev. Bras. Ginecol. Obstet.

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“…A curettage specimen should yield higher concordance in grading with the hysterectomy specimen, and thus more reliably detect occult malignancies. Fewer cases which have undergone curettage are upgraded at the time of hysterectomy compared to the biopsy (10% from curettage versus 26% from biopsy) [58] . We note one rare case of uterine carcinosarcoma of the heterologous type which was reported after a failed conservative treatment for presumed endometrial carcinoma from endometrial sampling [59] .…”

Section: Myometrial Invasionmentioning

confidence: 99%

Fertility-Sparing in Endometrial Cancer

Tangjitgamol

Manusirivithaya²,

Hanprasertpong³

2009

Gynecol Obstet Invest

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Because endometrial cancer (EMC) patients frequently present at an early stage of disease, most have favorable outcomes, thus their quality of life after treatment is as important a consideration as a cure of cancer. This issue is especially important when EMC is encountered in younger or reproductive ages when the afflicted woman has not achieved her fertility function. It is a complicated situation when a physician encounters a request or question from a woman with EMC or her family concerning whether she could conceive a child prior to a definite cancer treatment. Despite being an interesting issue, there are only a few studies with definite treatment guidelines or any evidence-based recommendations concerning conservative treatment for EMC. Thus, we undertook this study to explore various considerations regarding the criteria and caveats for the management of EMC women who desire to preserve their fertility function. An algorithm guideline for conservative fertility treatment for EMC is also presented.

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Comparison of D&C and office endometrial biopsy in predicting final histopathologic grade in endometrial cancer

Cited by 117 publications

References 8 publications

Progestins in the Fertility-Sparing Treatment and Retreatment of Patients With Primary and Recurrent Endometrial Cancer

Progestins in the Fertility-Sparing Treatment and Retreatment of Patients With Primary and Recurrent Endometrial Cancer

Dilatação e Curetagem na Avaliação do Sangramento Uterino Anormal: Achados Histopatológicos e Relação Custo/Benefício

Fertility-Sparing in Endometrial Cancer

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