Cancer of the corpus uteri

Amant, Frédéric; Mirza, Mansoor Raza; Koskas, Martin; Creutzberg, Carien L.

doi:10.1016/j.ijgo.2015.06.005

Cited by 67 publications

(34 citation statements)

References 114 publications

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“…It is widely accepted that high tumor grade, non-endometrioid histology, lymphovascular space invasion, and deep myometrial invasion are predictors of poor prognosis in endometrial carcinoma and important parameters to decide on individualized treatment [2]. Although many studies reported on reproducibility of tumor grading and histological typing, reports on reproducibility of assessment of MI and lymphovascular invasion are limited [18–21].…”

Section: Discussionmentioning

confidence: 99%

“…Endometrial carcinoma is the most common gynecological malignancy in developed countries, and its incidence is increasing [1, 2]. Primary treatment of endometrial carcinoma consists predominantly of hysterectomy and bilateral salpingo-oophorectomy.…”

Section: Introductionmentioning

confidence: 99%

“…Additional staging is typically undertaken for non-endometrioid and high-grade endometrioid carcinomas and when tumor stage is advanced. Most patients are diagnosed with FIGO stage I disease and low-grade (grade 1 or 2) endometrioid histology and have a good prognosis [2]. After primary surgery, the decision to administer adjuvant radiotherapy to prevent locoregional recurrences relies on the presence of predictors of poor outcome, such as high tumor grade, lymphovascular invasion, deep myometrial invasion (MI), and patient age >60 years [2].…”

Section: Introductionmentioning

confidence: 99%

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Reproducibility of measurement of myometrial invasion in endometrial carcinoma

et al. 2016

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Myometrial invasion (MI) as a percentage (%MI), categorized into <50 or ≥50 %, is an important predictor of prognosis in endometrial carcinoma. Recent studies suggest that tumor-free distance (TFD) to serosa and the absolute depth of invasion (DOI) might be stronger predictors of prognosis. Although reproducibility is important in clinical practice for patient prognostication and treatment, reproducibility of these methods for the measurement of MI is largely unknown. One or two slides from 50 patients with FIGO stage I endometrioid endometrial carcinoma were viewed by seven gynecological pathologists, who were requested to measure %MI, TFD, and DOI. We categorized %MI as <50 % (including no MI) or ≥50 %, TFD as ≤1.75 or >1.75 mm (including no MI), ≤7 or >7 mm (including no MI), and ≤10 or >10 mm (including no MI) and DOI as <4 mm (including no MI) or ≥4 mm. Light’s kappa for multi-rater agreement was calculated. The %MI, TFD, and DOI could be measured in 88, 83, and 79 % of cases, respectively. Kappa was 0.75 for %MI, 0.77, 0.73, and 0.69 respectively for TFD with cutoffs of 1.75, 7, and 10 mm, and 0.59 for DOI. Pathologists reach substantial agreement when measuring %MI and TFD and moderate agreement when measuring DOI. The %MI can be measured in more cases than TFD and DOI. This supports the use of %MI in daily clinical practice, but future studies should compare %MI and TFD more extensively, including inter-observer variability.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Reproducibility of measurement of myometrial invasion in endometrial carcinoma

et al. 2016

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“…Endometrial carcinoma is the most common of all the gynecologic malignancies and its incidence is rising (1,2). Surgical staging is an important determinant of adjuvant therapy.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of tumor‑free distance and depth of myometrial invasion as prognostic factors in endometrial cancer

et al. 2018

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Abstract. The aim of the study was to investigate whether the tumor free distance (TFD), which is the distance in millimeters between the deepest point of invasion and the serosal surface, and absolute depth of invasion (DMI), the distance in millimeters between the endomyometrial junction and the deepest point of myometrial invasion, are useful in surgical staging and in predicting prognosis. The present study retrospectively analyzed 62 cases of endometrial carcinoma with complete surgical staging, carried out over a 4 and half-year period (January 2003 to June 2007). All surgicopathological findings including surgical stages, histological type and grade, myometrial invasion, lymphovascular space invasion, cervical and adnexal involvement, and lymph node metastasis were abstracted from medical records and pathological reports. Univariate and multivariate analyses were performed comparing TFD, DMI and the percentage of mypmetrial invasion (MI) with established prognostic factors. A total of 62 patients were included in the study. A total of 52 (84%) had endometrioid carcinomas and 31 patients (60%) had grade 1 cancer. The deepest MI was <50% in 32 patients (52%). Median DMI was 2.7 mm (range 0-15 mm). Median TFD was 3 mm (range 0-19 mm). There was lymphovascular space invasion (LVSI) in 11 patients (17.5%), cervical involvement in 11 patients (17.5%), extra-uterine extension in 9 cases (14%) and lymph node metastasis in 12 patients (22%). It was demonstrated that 50% MI was significantly associated with prognostic factors (cervical involvement, type 2 carcinomas and LVSI, and was a significant predictor of the 5-year overall survival rate and recurrence-free survival (P=0.05, P=0.01). No significant association was observed between DMI and TFD with clinicopathological parameters and survival rates. The importance of DMI in predicting recurrence of disease was observed to be highest in terms of sensitivity and specificity. The cut-off value with the highest sensitivity and specificity crossing the receive operating characteristic curve was calculated to be 3 mm for DMI and 2.5 mm for TFD. The results indicate that DMI is a superior predictive factor of recurrence of the disease compared with TFD. However, further studies are required in order to prove the prognostic usefulness of these parameters and then to improve management of endometrial cancer. IntroductionEndometrial carcinoma is the most common of all the gynecologic malignancies and its incidence is rising (1,2). Surgical staging is an important determinant of adjuvant therapy. Whilst most patients with early stage disease have a good prognosis, the prognosis for patients with recurrent or advanced disease at presentation, i.e., advanced stage, incurable by surgery or radiotherapy, is poor. The most important parameter to elaborate the surgical stage is the depth of myometrial invasion (3,4). The percentage of myometrial invasion (%MI) is routinely determined in hysterectomy specimens and categorized as greater than or less than 50% and it is one of the ...

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“…Однако около 30 % больных имеют опасную сопутствующую пато-логию и находятся в возрасте старше 70 лет. Это часто служит поводом для длительного обследования больных у смежных специалистов и отказа от операции [1][2][3][4][5][6].…”

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