Diagnostic performance of intraoperative assessment in grade 2 endometrioid endometrial carcinoma

Abstract

Background Endometrial carcinoma is the most common gynecologic malignancy in developed countries. Grade 2 carcinoma is associated with pelvic lymph-node metastasis, depending on selected risk factors. Intraoperative assessment (IOA) can identify patients at risk for lymph node metastasis who should undergo staging surgery. Our objective was to establish the diagnostic precision of IOA in determining the need for surgical staging in grade 2 endometrioid endometrial carcinoma. Methods Two hundred twenty-two patients underwent IOA. Results were compared to the final pathology report. The accuracy of the IOA parameters was calculated. Variables were evaluated in patients with positive versus negative IOA. Overall and disease-free survivals were calculated according to IOA, lymphadenectomy, and nodal metastasis. Results IOA was positive in 80 patients. It showed an accuracy of 76.13% when compared with the postoperative assessment. The best individual parameter was myometrial invasion. Nodal metastasis was observed in 16 patients in the positive IOA group and 7 patients in the negative group. Patients with lymph node metastasis had a 5-year overall survival rate of 80.9%, whereas patients without metastasis had a 5-year overall survival rate of 97.9%. Conclusions IOA is an adequate tool to identify high-risk patients in grade 2 endometrial carcinoma. Myometrial invasion is the individual parameter that yields the highest diagnostic precision.

The role of intraoperative consultation in the management of ovarian masses and endometrial carcinomas: a 7-year experience

“…MI depth may be the most important parameter in EC staging, because it is considered predictive for lymph node metastases [24,25]. In many current guidelines on ECs, IC is replaced by algorithms based on sentinel lymph node procedure.…”

“…However, IC remains a viable option for patients with no mapping on a hemi-pelvis, as lymph node dissection may be omitted in these patients according to the result of IC, as stated in the latest The National Comprehensive Cancer Network (NCCN) uideline on uterine neoplasms [4]. MI depth allows to identify high-risk EC patients [24,25].…”

Development of a portable Raman device with artificial intelligence method for the detection and staging of endometrial cancer

“…Also, lymph node removal may lead to an irreversible chronic condition, lymphedema at later stages of life. Hence, quick, intra‐operative subtyping of endometrial cancer is critical for surgeons to decide the extent of surgery, reduce the duration of surgery, and thus alleviate morbidity factors [2]. Consequently, a point‐of‐care biopsy device that is based on inherent bio‐molecular signatures of the tissue can be immensely helpful for clinicians, to get near real‐time results.…”