[Re-evaluation of hysteroscopy in the diagnosis of uterine endometrial cancer].

To evaluate the clinical value of hysteroscopy in the management of endometrial cancer, findings in 3,681 patients with endometrial cancer treated between 1985 and 1989 at 167 hospitals in Japan were analyzed. In 1,040 of these patients, hysteroscopy was performed before operation. Pre-operative staging by fractional curettage with or without hysteroscopy was compared with post-operative histological diagnoses. The accuracy rates of diagnosis at final stages I and II were 91.4% and 79.4%, respectively, with hysteroscopy. There figures were not significantly different from those of 91.4% and 77.7% without hysteroscopy. The accuracy rate for diagnosis at the final stage I was 98.0% with the hystero-fiberscope and significantly higher than that with rigid hysteroscopy (86.0%). Tumor cells in the pelvic cavity were examined at the time of operation in 1,115 patients. Tumor cells were found in 8.5% of those in stage I, 18.8% of those in stage II, 64.7% of those in stage III and 75.0% of those in Stage IV by hysteroscopy. These values were not significantly different from those of 7.3%, 22.7%, 57.1% and 81.1%, respectively, observed without hysteroscopy. These findings indicate that hystero-fiberscopy might be valuable for the pre-operative diagnosis of endometrial cancer, but has no effect on cytological malignancy in the peritoneal cavity.