Evaluation of pretreatment transvaginal ultrasonography in the management of patients with endometrial carcinoma

Shipley, Charles F.; Smith, Sidney T.; Dennis, Edward J.; Nelson, George H.

doi:10.1016/s0002-9378(11)91420-3

Cited by 20 publications

(7 citation statements)

References 5 publications

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“…Our results were similar to those of earlier studies: sensitivity was 79% and NPV 86% with a lower specificity (72%) (5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15) . In contrast with the other studies, ours was performed in several clinics as part of the routine workup by sonographers or gynecologists.…”

Section: Discussionsupporting

confidence: 92%

“…The histology results of the curettage and definitive specimens were comparable in 74% of the patients. The tumor was poorly differentiated in the definitive specimen more often than in the curettings, a fact already known from the literature (12,23,25) . When the factors age, preoperative TVS results, and histology results (curettings) were combined, we correctly identified 24 of the 30 high-risk patients; 6 were incorrectly classified as high-risk patients (specificity 88%, PPV 80%).…”

Section: Discussionmentioning

confidence: 63%

“…Transvaginal sonography (TVS) has been used during the past few years to preoperatively determine the myometrial infiltration of endometrial cancer (5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15) . The present study was undertaken to evaluate preoperative TVS for myometrial invasion assessment in daily practice in various university and nonuniversity hospitals.…”

mentioning

confidence: 99%

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Preoperative selection of patients with low-stage endometrial cancer at high risk of pelvic lymph node metastases

Van Doorn,

van der Zee,

Peeters

et al. 2002

Int J Gynecol Cancer

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The goal of this study was to determine diagnostic accuracy of preoperative transvaginal sonography (TVS) to assess myometrial infiltration in patients with endometrial cancer and to determine the possibility of preoperatively selecting low-stage endometrial cancer patients at high risk of lymph node metastases. The depth of myometrial infiltration of endometrial cancer was assessed using TVS before or after curettage. Infiltration was classified as superficial if less than half of the myometrium was involved, otherwise it was classified as deep infiltration. Results were compared with the histology results of the definitive specimens. Patients were classified as high risk when they satisfied two of the following three criteria: 60 years of age or older; deep myometrial infiltration; and poorly differentiated or undifferentiated tumor. A total of 93 patients from 11 clinics were analyzed. The mean age was 66.1 years (SD ± 11.4). The sonography and histology findings were in agreement in 69 of 93 patients. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV), of “deep infiltration” by preoperative TVS were 79% (95% CI 0.65–0.93), 72% (95% CI 0.61–0.83), 61% (95% CI 0.46–0.75), and 86% (95% CI 0.76–0.96), respectively. Combining tumor grade and myometrial infiltration in the hysterectomy specimen and age, 30 of 81 patients were classified as high-risk patients. Sensitivity and PPV, specificity, and NPV for preoperative diagnosis of high risk were 80% (95% CI 0.65–0.94) and 88% (95% CI 0.79–0.97), respectively. Preoperative assessment of myometrial tumor infiltration using just TVS is only moderately reliable in endometrial cancer patients. If the results of TVS, however, are combined with the patient's age and the degree of tumor differentiation in curettings, it is possible to preoperatively select endometrial cancer patients with a high risk of pelvic lymph node metastases with sufficient reliability.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 63%

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Preoperative selection of patients with low-stage endometrial cancer at high risk of pelvic lymph node metastases

Van Doorn,

van der Zee,

Peeters

et al. 2002

Int J Gynecol Cancer

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“…3 Among these, transvaginal ultrasonography has been demonstrated to predict the depth of invasion as well as the tumor volume. 21 At least in part, our data are likely to reflect insufficient use of such techniques. In particular, transvaginal ultrasonography was still incompletely available during the study period, and the computed tomography services were often saturated.…”

Section: Discussionmentioning

confidence: 88%

Frequency and Determinants of Lymphadenectomy in Endometrial Carcinoma: A Population-Based Study From Northern Italy

Amadori¹,

Bucchi

Gori

et al. 2001

Ann Surg Oncol

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“…Transvaginal sonography (TVS) has been used during the past few years to preoperatively determine the myometrial infiltration of endometrial cancer (5–15) . The present study was undertaken to evaluate preoperative TVS for myometrial invasion assessment in daily practice in various university and nonuniversity hospitals.…”

mentioning

confidence: 99%

Gynecologic oncology: a discipline or a profession?

Heintz¹

2002

Int J Gynecol Cancer

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Abstract. van Doorn HC, van der Zee AGJ, Peeters PHM, Kroeks MVAM, van Eijkeren MA. Preoperative selection of patients with low‐stage endometrial cancer at high risk of pelvic lymph node metastases. The goal of this study was to determine diagnostic accuracy of preoperative transvaginal sonography (TVS) to assess myometrial infiltration in patients with endometrial cancer and to determine the possibility of preoperatively selecting low‐stage endometrial cancer patients at high risk of lymph node metastases. The depth of myometrial infiltration of endometrial cancer was assessed using TVS before or after curettage. Infiltration was classified as superficial if less than half of the myometrium was involved, otherwise it was classified as deep infiltration. Results were compared with the histology results of the definitive specimens. Patients were classified as high risk when they satisfied two of the following three criteria: 60 years of age or older; deep myometrial infiltration; and poorly differentiated or undifferentiated tumor. A total of 93 patients from 11 clinics were analyzed. The mean age was 66.1 years (SD ± 11.4). The sonography and histology findings were in agreement in 69 of 93 patients. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV), of “deep infiltration” by preoperative TVS were 79% (95% CI 0.65–0.93), 72% (95% CI 0.61–0.83), 61% (95% CI 0.46–0.75), and 86% (95% CI 0.76–0.96), respectively. Combining tumor grade and myometrial infiltration in the hysterectomy specimen and age, 30 of 81 patients were classified as high‐risk patients. Sensitivity and PPV, specificity, and NPV for preoperative diagnosis of high risk were 80% (95% CI 0.65–0.94) and 88% (95% CI 0.79–0.97), respectively. Preoperative assessment of myometrial tumor infiltration using just TVS is only moderately reliable in endometrial cancer patients. If the results of TVS, however, are combined with the patient's age and the degree of tumor differentiation in curettings, it is possible to preoperatively select endometrial cancer patients with a high risk of pelvic lymph node metastases with sufficient reliability.

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Evaluation of pretreatment transvaginal ultrasonography in the management of patients with endometrial carcinoma

Cited by 20 publications

References 5 publications

Preoperative selection of patients with low-stage endometrial cancer at high risk of pelvic lymph node metastases

Preoperative selection of patients with low-stage endometrial cancer at high risk of pelvic lymph node metastases

Frequency and Determinants of Lymphadenectomy in Endometrial Carcinoma: A Population-Based Study From Northern Italy

Gynecologic oncology: a discipline or a profession?

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