Should Preoperative Pathology Be Used to Select Patients for Surgical Staging in Endometrial Cancer?

Francis, Julie A.; Mr, Weir; Ettler, Helen C.; Qiu, Feng; Kwon, Janice S.

doi:10.1111/igc.0b013e3181a1a657

Cited by 29 publications

(22 citation statements)

References 42 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Additional factors should be considered in selecting patients for a surgical staging procedure. 6 Transvaginal ultrasound measuring the thickness of the endometrium also represents a standard minimally invasive method for diagnosing EC. In a study of patients having postmenopausal bleeding, using a cutoff of 4 mm, it was found that transvaginal ultrasound had 100% sensitivity and 60% specificity.…”

Section: Early Detection and Diagnosismentioning

confidence: 99%

“…10 and EPS8L2 in representative examples of endometrial carcinoma (upper panels). Specific staining at tumor glands (T) in contrast to faint labeling in normal glands (n) and stroma (st) in different histological types including endometrioid (1,3,4,5,6,7,8), serous (2) and clear cell (9) carcinomas. Western blot analysis of P4HB in paired samples including tumor tissue (T) and adjacent normal endometrium (N) from four different patients.…”

Section: Early Detection and Diagnosismentioning

confidence: 99%

See 1 more Smart Citation

Molecular markers of endometrial carcinoma detected in uterine aspirates

Colás¹,

Pérez

Cabrera

et al. 2011

Intl Journal of Cancer

108

View full text Add to dashboard Cite

Endometrial cancer (EC) is the most frequent of the invasive tumors of the female genital tract. Although usually detected in its initial stages, a 20% of the patients present with advanced disease. To date, no characterized molecular marker has been validated for the diagnosis of EC. In addition, new methods for prognosis and classification of EC are needed to combat this deadly disease. We thus aimed to identify new molecular markers of EC and to evaluate their validity on endometrial aspirates. Gene expression screening on 52 carcinoma samples and series of real‐time quantitative PCR validation on 19 paired carcinomas and normal tissue samples and on 50 carcinoma and noncarcinoma uterine aspirates were performed to identify and validate potential biomarkers of EC. Candidate markers were further confirmed at the protein level by immunohistochemistry and Western blot. We identified ACAA1, AP1M2, CGN, DDR1, EPS8L2, FASTKD1, GMIP, IKBKE, P2RX4, P4HB, PHKG2, PPFIBP2, PPP1R16A, RASSF7, RNF183, SIRT6, TJP3, EFEMP2, SOCS2 and DCN as differentially expressed in ECs. Furthermore, the differential expression of these biomarkers in primary endometrial tumors is correlated to their expression level in corresponding uterine fluid samples. Finally, these biomarkers significantly identified EC with area under the receiver‐operating‐characteristic values ranging from 0.74 to 0.95 in uterine aspirates. Interestingly, analogous values were found among initial stages. We present the discovery of molecular biomarkers of EC and describe their utility in uterine aspirates. These findings represent the basis for the development of a highly sensitive and specific minimally invasive method for screening ECs.

show abstract

Section: Early Detection and Diagnosismentioning

confidence: 99%

Section: Early Detection and Diagnosismentioning

confidence: 99%

Molecular markers of endometrial carcinoma detected in uterine aspirates

Colás¹,

Pérez

Cabrera

et al. 2011

Intl Journal of Cancer

108

View full text Add to dashboard Cite

show abstract

“…23 Francis et al, 24 applying this system to a Canadian cohort, demonstrated better feasibility for the Lax binary system by reaching similar agreement rates between specimens evaluated in teaching and community hospitals (83% vs 89%). 24 Considering the findings of our study, which showed a significant rate of interchangeability between G1 and G2 lesions but relatively rare downgrading of G3 biopsies, this method seems a good alternative to the FIGO system currently in use.…”

Section: Discussionmentioning

confidence: 92%

Agreement Between Preoperative Endometrial Sampling and Surgical Specimen Findings in Endometrial Carcinoma

Garcia¹,

Appel

Rivero

et al. 2017

International Journal of Gynecological Cancer

View full text Add to dashboard Cite

show abstract

“…The study by Sany et al that describes 191 cases shows that pre-operative endometrial sampling has good overall histological correlation with hysterectomized corpus specimens 5. Francis et al demonstrated with 1804 patients that the concordance rates between pre-operative and post-operative pathology were 73% with grade 1, 52% with grade 2, and 53% with grade 3, respectively 6. The study by Kwon et al observed with 450 patients that the overall discrepancy rate between pre-operative and post-operative pathology was 42.7% 7.…”

Section: Discussionmentioning

confidence: 99%

“…To date, the largest study on this topic included 1804 patients, and it found that the concordance rates of grade 1, grade 2, and grade 3 endometrioid adenocarcinomas were 73%, 52%, and 53%, respectively. Moderate correlations between pre-operative endometrial biopsies and post-operative permanent pathologies were evident based on the observed Spearman correlation coefficient (ρ) of 0.52 6. Clinically discordant pathology, especially when the final pathology is a lower grade than the pre-operative pathology (downgrade discordancy), can be difficult to interpret, and clinicians do not have clear guidelines for choosing adjuvant therapies in such cases.…”

Section: Introductionmentioning

confidence: 99%

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

Shiozaki

Miwa

Sakuma

et al. 2019

Int J Gynecol Cancer

View full text Add to dashboard Cite

ObjectiveWe conducted a retrospective study to evaluate the correlation between pre-operative and post-operative histological diagnoses on endometrial cancer, and to describe the treatments and outcomes when post-operative diagnoses are downgraded from pre-operative histology.MethodsPatients who underwent surgery for endometrial cancer in our facility between 2010 and 2013 were enrolled in the study. The definition of downgrade discordance is in accordance with the following criteria: 1) the pre-operative and post-operative histological diagnoses were both endometrioid and the final pathology was a lower grade than the pre-operative pathology and 2) the pre-operative diagnosis was not endometrioid, whereas the post-operative diagnosis was endometrioid grade 2 or less.ResultsA total of 250 patients were enrolled, and the concordance rates were 56% for endometrioid adenocarcinoma grade 1 (EMG1), 67% for EMG2, 67% for EMG3, 82% for carcinosarcoma, 71% for serous carcinoma, and 67% for clear cell carcinoma. Eighteen cases (6.6%) were identified as downgrade discordancy. Of the 18 patients, the triage for adjuvant therapy remained the same for 15 cases (83%), all of whom had no evidence of disease at their last visit. Three cases had discordances with respect to triage for adjuvant therapy; the therapies were triaged based on post-operative diagnosis. Of these patients one had a recurrence.ConclusionsGood correlation was observed between pre-operative and final histological diagnoses of endometrioid carcinoma (56%–67%) and type 2 carcinoma (67%–82%). Approximately 7% (18/250) of patients had downgrade discordancy; however, triage for adjuvant therapy did not change for approximately 80% (15/18) of the patients with downgrade discordancy. Further studies are needed to evaluate the effectiveness of triages that are based on post-operative diagnoses.

show abstract

Should Preoperative Pathology Be Used to Select Patients for Surgical Staging in Endometrial Cancer?

Abstract: Preoperative biopsy has only a moderate ability to predict final pathology in endometrial cancer, and therefore, additional factors should be considered in selecting patients for a surgical staging procedure.

Cited by 29 publications

References 42 publications

Molecular markers of endometrial carcinoma detected in uterine aspirates

Molecular markers of endometrial carcinoma detected in uterine aspirates

Agreement Between Preoperative Endometrial Sampling and Surgical Specimen Findings in Endometrial Carcinoma

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

Contact Info

Product

Resources

About