Correlation between pre-operative and final histological diagnosis on endometrial cancer

Shiozaki, Takaya; Miwa, Maiko; Sakuma, Takashi; Suzuki, Kazutoshi; Kogiku, Ai; Yamamoto, Keizô; Senda, Tokihiro; Yano, Hiroko; Kitai, Miho; Matsuoka, Katsuyoshi; Sudo, Tamotsu; Nagao, Shoji; Yamaguchi, Satoshi

doi:10.1136/ijgc-2018-000041

Cited by 10 publications

(4 citation statements)

References 9 publications

(10 reference statements)

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“…Undetermined pre-operative type and histology was found in 206 patients, and 15 cases with pre-operative diagnosis of type I EC were corrected as type II EC after hysterectomy, most probably because of the limited sampling of pre-operative endometrial biopsy ( 22 ). The concordance rates of the pre-operative and final pathological report are reported to be varied between 56 and 81% ( 23 ). 7.2% had downgrade discordance, and the most common type of downgrade was seen in type I EC ( 23 ).…”

Section: Discussionmentioning

confidence: 99%

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Predictive Value of Serum Cytokeratin 19 Level for the Feasibility of Conserving Ovaries in Endometrial Cancer

Chen

Xiong³

et al. 2021

Front. Med.

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Objective: To determine the predictive value of cytokeratin 19 (CK19) for evaluating the safety of ovarian preservation in patients with endometrial cancer (EC).Methods: Five hundred and seventeen EC patients hospitalized from November 2010 to June 2016 were reviewed retrospectively. Pre-operative tumor biomarkers including CA125, HE4, CK19, and CA19-9 were obtained. Predictive biomarkers associated with ovarian metastasis were selected using univariate and multivariate Logistic regression. The cut-off values were determined by receiver operating characteristic (ROC) curves. Kaplan-Meier method and Cox multivariate regression model was used to perform survival analysis.Results: Among clinical parameters and biomarkers included, age > 65, type II EC, CA125 ≥ 35 u/ml, CK19 > 3.3 ng/ml, and myometrial invasion ≥ 50% depth appeared as significant predictors of the risk of ovarian involvement in univariable logistic analysis. In multivariable analysis, CK19 > 3.3 ng/ml (OR = 11.541, 95%CI: 1.968–67.668, P = 0.007) and Type II EC (OR = 8.336, 95%CI: 1.456–47.722, P = 0.017) were independent risk predictors of ovarian metastasis in pre-menopausal women. In pre-menopausal women with Type I EC (n = 142), CK19 level could satisfactorily predict the risk of ovarian metastasis (AUC = 0.860, 95%CI: 0.792–0.912, P < 0.001), and when the cut-off point was set as 2.45 ng/ml, the negative predictive value and negative likelihood ratio were 99% and 0.19, with the maximum Youden index of 0.598.Conclusions: The present study advocates the necessity of incorporating serum CK19 measurement into the pre-operative evaluation of EC, especially as extension of current standard approach with ovarian preservation counseling.

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Section: Discussionmentioning

confidence: 99%

“…The concordance rates of the pre-operative and final pathological report are reported to be varied between 56 and 81% ( 23 ). 7.2% had downgrade discordance, and the most common type of downgrade was seen in type I EC ( 23 ). Thus, improvement of accuracy of pre-operative pathology should be addressed in the future studies.…”

Section: Discussionmentioning

confidence: 99%

Predictive Value of Serum Cytokeratin 19 Level for the Feasibility of Conserving Ovaries in Endometrial Cancer

Chen

Xiong³

et al. 2021

Front. Med.

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“…7.2% had downgrade discordance, and the most common type of downgrade was seen in type I EC. 21 Based on the low possibility of downgrade post-operatively, thorough lymphadenectomy could be suggested for the curettagediagnosed type II EC. Other strategies such as combined diagnosis might increase the accuracy of curettage.…”

Section: Discussionmentioning

confidence: 99%

<p>Differential Impact of Systemic Lymphadenectomy Upon the Survival of Patients with Type I vs Type II Endometrial Cancer: A Retrospective Observational Cohort Study</p>

Chen

Xiong

et al. 2020

CMAR

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Purpose: To determine whether systemic lymphadenectomy exerts a similar effect on the survival of patients with either type I or type II endometrial cancer (EC). Patients and Methods: In this retrospective study, 682 eligible patients diagnosed with EC were typed according to the pathological reports. The thoroughness of lymphadenectomy was evaluated by the lymph node number of which the cutoff value was determined by the receiver operator characteristic (ROC) curve and Youden index. The impact of thoroughness on the survival of both types was analyzed, respectively, by Kaplan Meier (K-M) method and further evaluated in subgroups with and without lymphatic metastasis. Independent prognostic factors of survival were selected by proportional hazard regression (Cox) model. Results: The cutoff level of lymph node number was 20. The differential impact of the lymph node number removed on survival was noted when patients with different types were analyzed separately. Among type II EC, those with >20 lymph nodes removed presented better overall survival (OS) than those with ≤20 (p=0.002). The number of lymph nodes removed >20 was proved as an independent factor for improved OS in type II EC (HR=0.329,95% CI: 0.123-0.881, p=0.0027). In the subgroup of type II with >20 lymph nodes resected, similar 5-year OS rates were observed in those with or without identified positive node (90.9% vs 92.9%, p=0.965). Type I EC seemed unbeneficial from such a procedure. Conclusion: Systemic lymphadenectomy could enhance the OS of type II EC other than type I.

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“…Endometrial biopsy is a crucial method to diagnosing EC, but it has some false-negatives compared with the final surgical pathology. Moreover, the type, grade, myometrial invasion, and lymphatic vascular infiltration cannot be accurately evaluated because of the limitation of materials and heterogeneity of tumor tissue, which may underestimate cancer risk ( 8 , 9 ). Recently, magnetic resonance imaging (MRI) as a non-invasive preoperative risk assessment method that has been widely used in malignant tumors with functional and molecular imaging technology and reflects both the local and overall characteristics of lesions.…”

Section: Introductionmentioning

confidence: 99%

Nomograms of Combining Apparent Diffusion Coefficient Value and Radiomics for Preoperative Risk Evaluation in Endometrial Carcinoma

Zhang

Fang

et al. 2021

Front. Oncol.

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ObjectivesTo evaluate the value of nomogram models combining apparent diffusion coefficient (ADC) value and radiomic features on magnetic resonance imaging (MRI) in predicting the type, grade, deep myometrial invasion (DMI), lymphovascular space invasion (LVSI), and lymph node metastasis (LNM) of endometrial carcinoma (EC) preoperatively.MethodsThis study included 210 EC patients. ADC value was calculated, and radiomic features were measured on T2-weighted images. The univariate and multivariate logistic regressions and cross-validations were performed to reduce valueless features, then radiomics signatures were developed. Nomogram models using ADC combined with radiomic features were developed in the training cohort. The receiver operating characteristic (ROC) curve was performed to estimate the diagnostic efficiency of nomogram models by the area under the curve (AUC) in the training and validation cohorts.ResultsThe ADC value was significantly different between each subgroup. Radiomic features were ultimately limited to four features for type, six features for grade, six features for DMI, four features for LVSI, and eight features for LNM for the nomogram models. The AUC of the nomogram model combining ADC value and radiomic features in the training and validation cohorts was 0.851 and 0.867 for type, 0.959 and 0.880 for grade, 0.839 and 0.766 for DMI, 0.816 and 0.746 for LVSI, and 0.910 and 0.897 for LNM.ConclusionsThe nomogram models of ADC value combined with radiomic features were associated with the type, grade, DMI, LVSI, and LNM of EC, and provide an effective, non-invasive method to evaluate preoperative risk stratification for EC.

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Correlation between pre-operative and final histological diagnosis on endometrial cancer

Cited by 10 publications

References 9 publications

Predictive Value of Serum Cytokeratin 19 Level for the Feasibility of Conserving Ovaries in Endometrial Cancer

Predictive Value of Serum Cytokeratin 19 Level for the Feasibility of Conserving Ovaries in Endometrial Cancer

<p>Differential Impact of Systemic Lymphadenectomy Upon the Survival of Patients with Type I vs Type II Endometrial Cancer: A Retrospective Observational Cohort Study</p>

Nomograms of Combining Apparent Diffusion Coefficient Value and Radiomics for Preoperative Risk Evaluation in Endometrial Carcinoma

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