IMR Press / EJGO / Volume 39 / Issue 1 / DOI: 10.12892/ejgo3581.2018
Open Access Original Research
Assessment of different pre- and intra-operative strategies to predict the actual ESMO risk group and to establish the appropriate indication of lymphadenectomy in endometrial cancer
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1 Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges-Pompidou, Chirurgie Cancérologique Gynécologique et du Sein, Paris, France
2 Centre Hospitalier Intercommunal de Poissy Saint Germain, Service de Gynécologie-Obstétrique, Paris, France
3 EA 7285, Risques Cliniques et Sécurité en Santé des Femmes, Université Versailles Saint Quentin en Yvelines, Faculté de Médecine, Paris, France
4 Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges-Pompidou, Imagerie, Paris, France
5 Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges-Pompidou, Anatomopathologie, Paris, France
6 Université Paris Descartes, Sorbonne Paris Cité, Faculté de Médecine, Paris, France
7 INSERM UMR-S 1124, Université Paris Descartes, Paris, France
Eur. J. Gynaecol. Oncol. 2018 , 39(1), 19–26; https://doi.org/10.12892/ejgo3581.2018
Published: 10 February 2018
Abstract

Purpose of investigation: The objective of this study was to evaluate the best pre- and intra-operative strategy to determine the European Society for Medical Oncology (ESMO) risk group. Materials and Methods: Twelve algorithms, integrating endometrial biopsy for histological type and tumour grade, and ultrasound and/or magnetic resonance imaging (MRI) ± intra-operative examination for determination of myometrial invasion, were built. The diagnostic values of each algorithm to predict high- and low-risk group were calculated. Results: For the prediction of high-risk group, the best algorithm was endometrial biopsy and ultrasound, combined with MRI in case of myometrial invasion < 50% ± intra-operative examination in case of myometrial invasion < 50% on MRI. For the prediction of low-risk group, the two best algorithms were endometrial biopsy and ultrasound or MRI, combined with MRI or ultrasound in case of myometrial invasion < 50% and intra-operative examination in case of discrepancy between both exams. Conclusion: The present study suggests that the best strategy to predict actual ESMO risk group is endometrial biopsy and transvaginal ultrasound ± MRI and intra-operative examination in case of myometrial invasion < 50% on ultrasound.
Keywords
Endometrial cancer
Lymphadenectomy
Ultrasound
MRI
Intra-operative examination
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