RT Journal Article
SR Electronic
T1 Correlation between pre-operative and final histological diagnosis on endometrial cancer
JF International Journal of Gynecologic Cancer
JO Int J Gynecol Cancer
FD BMJ Publishing Group Ltd
SP ijgc-2018-000041
DO 10.1136/ijgc-2018-000041
A1 Takaya Shiozaki
A1 Maiko Miwa
A1 Toshiko Sakuma
A1 Kazuhiro Suzuki
A1 Ai Kogiku
A1 Kasumi Yamamoto
A1 Tokihiro Senda
A1 Hiroko Yano
A1 Miho Kitai
A1 Kazuko Matsuoka
A1 Tamotsu Sudo
A1 Shoji Nagao
A1 Satoshi Yamaguchi
YR 2019
UL http://ijgc.bmj.com/content/early/2019/01/04/ijgc-2018-000041.abstract
AB Objective We 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.Methods Patients 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.Results A 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.Conclusions Good 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.