The oncological safety of hysteroscopy in the diagnosis of early-stage endometrial cancer: An Israel gynecologic oncology group study

Eur J Obstet Gynecol Reprod Biol. 2019 Dec:243:120-124. doi: 10.1016/j.ejogrb.2019.10.042. Epub 2019 Oct 31.

Abstract

Objective: To compare survival measures of women with early-stage endometrial cancer who underwent either hysteroscopy or a non-hysteroscopic procedure as a diagnostic procedure.

Study design: An Israel Gynecologic Oncology Group multicenter study of 1324 patients with stage I endometrial cancer who underwent surgery between 2002 and 2014. Patients were divided into two groups: hysteroscopy and non-hysteroscopy (curettage or office endometrial biopsy). Clinical, pathological, and survival measures were compared between the groups.

Results: There were 355 patients in the hysteroscopy group and 969 patients in the non-hysteroscopy group. The median follow-up was 52 months (range 12-120 months). There were no differences between the groups in the 5-year recurrence-free survival (90.2% vs. 88.2%; p = 0.53), disease-specific survival (93.4% vs. 91.7%; p = 0.5), and overall survival (86.2% vs. 80.6%; p = 0.22).

Conclusion: Our findings affirm that hysteroscopy does not compromise the survival of patients with early-stage endometrial cancer.

Keywords: Early stage; Endometrial cancer; Hysteroscopy; Survival.

MeSH terms

  • Adenocarcinoma, Clear Cell / diagnosis*
  • Adenocarcinoma, Clear Cell / mortality
  • Adenocarcinoma, Clear Cell / pathology
  • Adenocarcinoma, Clear Cell / therapy
  • Aged
  • Biopsy
  • Carcinoma, Endometrioid / diagnosis*
  • Carcinoma, Endometrioid / mortality
  • Carcinoma, Endometrioid / pathology
  • Carcinoma, Endometrioid / therapy
  • Carcinosarcoma / diagnosis*
  • Carcinosarcoma / mortality
  • Carcinosarcoma / pathology
  • Carcinosarcoma / therapy
  • Curettage
  • Disease-Free Survival
  • Endometrial Neoplasms / diagnosis*
  • Endometrial Neoplasms / mortality
  • Endometrial Neoplasms / pathology
  • Endometrial Neoplasms / therapy
  • Female
  • Follow-Up Studies
  • Humans
  • Hysterectomy
  • Hysteroscopy / statistics & numerical data*
  • Israel
  • Middle Aged
  • Neoplasm Recurrence, Local / epidemiology
  • Neoplasm Staging
  • Prognosis
  • Salpingo-oophorectomy