Sarah Vieillefosse1, Cyrille Huchon2, Foucauld Chamming's3, Marie-Aude Le Frère-Belda4, Laure Fournier5, Charlotte Ngô6, Fabrice Lécuru6, Anne-Sophie Bats6. 1. Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges-Pompidou, Chirurgie Cancérologique Gynécologique et du Sein, Paris, France. Electronic address: sarah.vieillefosse@aphp.fr. 2. Centre Hospitalier Intercommunal de Poissy Saint Germain, Service de Gynécologie-Obstétrique, Paris, France; EA 7285, Risques cliniques et sécurité en santé des femmes, Université Versailles Saint Quentin en Yvelines, Faculté de Médecine, Paris, France. 3. Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges-Pompidou, Imagerie, Paris, France. 4. Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges-Pompidou, Anatomopathologie, Paris, France. 5. Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges-Pompidou, Imagerie, Paris, France; Université Paris Descartes, Sorbonne Paris Cité, Faculté de médecine, Paris, France. 6. Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges-Pompidou, Chirurgie Cancérologique Gynécologique et du Sein, Paris, France; Université Paris Descartes, Sorbonne Paris Cité, Faculté de médecine, Paris, France; INSERM UMR-S 1124, Université Paris Descartes, Paris, France.
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: Retrospective study on patients supported for endometrial cancer between 2006 and 2011. 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: During the study period, 159 patients were operated for endometrial cancer. On these 159 patients, 103 met the inclusion criteria. 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 2 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. There was no internal or external validation. CONCLUSION: Our 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.
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: Retrospective study on patients supported for endometrial cancer between 2006 and 2011. 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: During the study period, 159 patients were operated for endometrial cancer. On these 159 patients, 103 met the inclusion criteria. 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 2 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. There was no internal or external validation. CONCLUSION: Our 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.
Authors: Nicole Concin; Carien L Creutzberg; Ignace Vergote; David Cibula; Mansoor Raza Mirza; Simone Marnitz; Jonathan A Ledermann; Tjalling Bosse; Cyrus Chargari; Anna Fagotti; Christina Fotopoulou; Antonio González-Martín; Sigurd F Lax; Domenica Lorusso; Christian Marth; Philippe Morice; Remi A Nout; Dearbhaile E O'Donnell; Denis Querleu; Maria Rosaria Raspollini; Jalid Sehouli; Alina E Sturdza; Alexandra Taylor; Anneke M Westermann; Pauline Wimberger; Nicoletta Colombo; François Planchamp; Xavier Matias-Guiu Journal: Virchows Arch Date: 2021-02 Impact factor: 4.064