RT Journal Article SR Electronic T1 Should Preoperative Pathology Be Used to Select Patients for Surgical Staging in Endometrial Cancer? JF International Journal of Gynecologic Cancer JO Int J Gynecol Cancer FD BMJ Publishing Group Ltd SP 380 OP 384 DO 10.1111/IGC.0b013e3181a1a657 VO 19 IS 3 A1 Julie A. Francis A1 Michele M. Weir A1 Helen C. Ettler A1 Feng Qiu A1 Janice S. Kwon YR 2009 UL http://ijgc.bmj.com/content/19/3/380.abstract AB Introduction: The decision to offer surgical staging in endometrial cancer is often based on preoperative histology and grade from endometrial biopsy or dilatation and curettage. The primary objective of this study was to evaluate the concordance between preoperative and final pathology from a population-based study of endometrial cancer to address whether preoperative biopsy is a reliable determinant in selecting patients for surgical staging.Methods: Retrospective cohort study in Ontario, Canada, from 1996 to 2000. The study included all women with a preoperative diagnosis of endometrioid adenocarcinoma on endometrial biopsy or dilatation and curettage, followed by definitive surgery. All other histological types were excluded. Surgical staging rates were compared according to preoperative pathology. Primary outcome measure was the concordance between preoperative and final pathology, expressed as a Spearman correlation coefficient (ρ). A multivariable logistic regression estimated the effects of demographic variables and grade on our outcome measure.Results: There were 1804 evaluable cases in this study. For preoperative grades 1, 2, and 3 endometrioid adenocarcinoma, surgical staging rates were 9.1%, 13.7%, and 25.6%, respectively. Concordance rates with final pathology were 73%, 52%, and 53%, respectively. There was only moderate concordance between preoperative and final pathology (ρ = 0.52). There was no significant difference in concordance rates according to age, year, or hospital volume, but lower concordance rates among teaching hospitals.Conclusion: 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.