Pertinence du bilan préoperatoire dans l’évaluation du risque de métastases ganglionnaires d’un cancer endométrial

Groff, Benjamin D.; Pouget, O.; Stoll, Friederike; Mathelin, Carole; Jj, Baldauf; Akladios, Chérif

doi:10.1016/j.gyobfe.2013.08.003

Cited by 7 publications

(14 citation statements)

References 24 publications

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“…Interobserver variability in MRI and histology slide analysis can impair diagnostic performance. However our results are consistent with the literature [ 9 , 25 ]. Several authors have studied the correlation between preoperative and final histology [ 9 , 22 , 25 – 32 ].…”

Section: Discussionsupporting

confidence: 94%

“…However our results are consistent with the literature [ 9 , 25 ]. Several authors have studied the correlation between preoperative and final histology [ 9 , 22 , 25 – 32 ]. In terms of determining the tumour type, these studies report an accuracy rate of 74 % to 92 % [ 9 , 28 ], with no significant difference between the different sampling techniques, a finding comparable to our own results.…”

Section: Discussionsupporting

confidence: 94%

“…In terms of determining the tumour type, these studies report an accuracy rate of 74 % to 92 % [ 9 , 28 ], with no significant difference between the different sampling techniques, a finding comparable to our own results. In terms of determining the grade, these studies report an accuracy rate of 44 % to 94 % [ 9 , 22 , 25 , 28 , 29 ], with no significant difference between the different sampling techniques either, a finding comparable to our own results [ 22 , 25 , 26 , 28 , 29 ]. Similarly, numerous authors have addressed the diagnostic performance of MRI for evaluating the degree of myometrial, cervical and nodal invasion [ 21 , 33 – 37 ].…”

Section: Discussionsupporting

confidence: 88%

“…Similarly, numerous authors have addressed the diagnostic performance of MRI for evaluating the degree of myometrial, cervical and nodal invasion [ 21 , 33 – 37 ]. The results of our study are comparable to those in the literature [ 9 , 25 , 29 , 37 – 42 ] which reports an accuracy rate of between 66 % and 90 % and a positive likelihood ratio >5 for evaluation of the degree of myometrial invasion [ 1 ]. Few studies have specifically evaluated the performance of MRI for FIGO staging, which is a composite criterion [ 9 , 40 , 42 ].…”

Section: Discussionsupporting

confidence: 88%

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Are preoperative histology and MRI useful for classification of endometrial cancer risk?

et al. 2016

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BackgroundThe 2010 guidelines of the French National Cancer Institute (INCa) classify patients with endometrial cancer into three risk groups for lymph node invasion and recurrence on the basis of MRI and histological analysis of an endometrial specimen obtained preoperatively. The classification guides therapeutic choices, which may include pelvic and/or para-aortic lymphadenectomy. The purpose of this study was to evaluate the diagnostic performance of preoperative assessment to help identify intermediate- or high-risk patients requiring lymphadenectomy.MethodsThe study included all patients who underwent surgery for endometrial cancer between January 2010 and December 2013 at either Rennes University Hospital or Vannes Regional Hospital. The criteria for eligibility included a preoperative assessment with MRI and histological examination of an endometrial sample. A histological comparison was made between the preoperative and surgical specimens.ResultsAmong the 91 patients who underwent a full preoperative assessment, the diagnosis of intermediate- or high-risk endometrial cancer was established by MRI and histology with a sensitivity of 70 %, specificity of 82 %, positive predictive value (PPV) of 87 %, negative predictive value (NPV) of 61 %, positive likelihood ratio (LR+) of 3.8 and negative likelihood ratio (LR-) of 0.3. The risk group was underestimated in 32 % of patients and overestimated in 7 % of patients. MRI underestimated endometrial cancer stage in 20 % of cases, while endometrial sampling underestimated the histological type in 4 % of cases and the grade in 9 % of cases.ConclusionThe preoperative assessment overestimated or underestimated the risk of recurrence in nearly 40 % of cases, with errors in lesion type, grade or stage. Erroneous preoperative risk assessment leads to suboptimal initial surgical management of patients with endometrial cancer.

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Section: Discussionsupporting

confidence: 94%

Section: Discussionsupporting

confidence: 94%

Section: Discussionsupporting

confidence: 88%

Section: Discussionsupporting

confidence: 88%

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Are preoperative histology and MRI useful for classification of endometrial cancer risk?

et al. 2016

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“…Cette sous estimation du risque était due à la fois à la discordance anatomoradiologique pré et postopératoire et à la présence d'emboles lymphovasculaires découverts sur la pièce opératoire d'hystérectomie, ce qui concordait avec la littérature (15,(16)(17)(18)(19)(20)(21). En effet, les emboles représentent un facteur prédictif puissant d'envahissement ganglionnaire (22)(23)(24) et impactent la survie globale et sans récidive (25,26) .…”

Section: Patientes Et Design De L'étudeunclassified

Application des recommandations dans la prise en charge du cancer de l’endomètre en pratique clinique. Étude rétrospective bretonne

Kerdaniel

Davoine

Foucher

et al. 2016

Journal de Gynécologie Obstétrique et Biologie de la Reproducti

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To improve relevance of preoperative assessment in endometrial cancer, radiological and pathological expertise is required. However, even performed optimally, preoperative assessment does not allow correct risk stratification of lymph node involvement in endometrial cancer. This ineffective stratification leads to propose sentinel lymph node biopsy with hysterectomy in case of preoperative low risk endometrial cancer assessment.

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Performances de l’IRM dans le bilan d’extension locale préopératoire des cancers de l’endomètre : l’expérience nantaise

Coussoou¹,

Laigle-Quérat²,

Loussouarn³

et al. 2020

Gynécologie Obstétrique Fertilité & Sénologie

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Pertinence du bilan préoperatoire dans l’évaluation du risque de métastases ganglionnaires d’un cancer endométrial

Cited by 7 publications

References 24 publications

Are preoperative histology and MRI useful for classification of endometrial cancer risk?

Are preoperative histology and MRI useful for classification of endometrial cancer risk?

Application des recommandations dans la prise en charge du cancer de l’endomètre en pratique clinique. Étude rétrospective bretonne

Performances de l’IRM dans le bilan d’extension locale préopératoire des cancers de l’endomètre : l’expérience nantaise

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