Preoperative diagnosis of tumor grade and type in endometrial cancer by pipelle sampling and hysteroscopy: Results of a French study

Phelippeau, Juliette; Canlorbe, Geoffroy; Bendifallah, Sofiane; Naoura, Iptissem; Lefèvre, Marine; Ballester, Marcos; Daraı̈, Émile

doi:10.1016/j.suronc.2016.08.004

Cited by 30 publications

(13 citation statements)

References 27 publications

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“…One of the crucial difficulties in the management of patients with EC is to establish a guideline for when to perform lymphadenectomy associated with hysterectomy in the initial surgical management. To date, no imaging technique [69,70] or preoperative histological analysis [70,71,72] makes it possible to accurately define the risk of ganglionic invasion. A determination of miR expression in the primitive tumor tissue might provide some guidelines.…”

Section: Discussionmentioning

confidence: 99%

The Use of microRNAs in the Management of Endometrial Cancer: A Meta-Analysis

Delangle

Foucher

Larsen

et al. 2019

Cancers

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Introduction: Endometrial cancer (EC) is the most important gynecological cancer in terms of incidence. microRNAs (miRs), which are post-transcriptional regulators implicated in a variety of cellular functions including carcinogenesis, are particularly attractive candidates as biomarkers. Indeed, several studies have shown that the miR expression pattern appears to be associated with prognostic factors in EC. Our objective is to review the current knowledge of the role of miRs in carcinogenesis and tumor progression and their association with the prognosis of endometrial cancer. Materials and Method: We performed a literature search for miR expression in EC using MEDLINE, PubMed (the Internet portal of the National Library of Medicine) and The Cochrane Library, Cochrane databases “Cochrane Reviews” and “Clinical Trials” using the following keywords: microRNA, endometrial cancer, prognosis, diagnosis, lymph node, survival, plasma, FFPE (formalin-fixed, paraffin-embedded). The miRs were classified and presented according to their expression levels in cancer tissue in relation to different prognostic factors. Results: Data were collected from 74 original articles and 8 literature reviews which described the expression levels of 261 miRs in ECs, including 133 onco-miRs, 110 miR onco-suppressors, and 18 miRs with discordant functions. The review identified 30 articles studying the expression pattern of miR in neoplastic endometrial tissue compared to benign and/or hyperplastic tissues, 12 articles detailing the expression profile of miRs as a function of lymph node status, and 14 articles that detailed the expression pattern of miRs in endometrial tumor tissue according to overall survival or in the absence of recurrence. Conclusions: The findings presented here suggest that miR analysis merits a role as a prognostic factor in the management of patients with endometrial cancer.

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Section: Discussionmentioning

confidence: 99%

The Use of microRNAs in the Management of Endometrial Cancer: A Meta-Analysis

Delangle

Foucher

Larsen

et al. 2019

Cancers

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“…Moreover, the discordance rates vary according to grades and other factors, such as the method of sample collection. [16][17][18][19][20][21][22][23][24] Thus, the study of preoperative endometrial sampling as a predictor of surgical specimen grading and its value on surgical decisions and patient prognosis is still debated.…”

Section: Introductionmentioning

confidence: 99%

Assessment of Preoperative Endometrial Histopathological Sampling as a Predictor of Final Surgical Pathology in Endometrial Cancer

Piotto

Focchi

Marques

et al. 2020

Rev Bras Ginecol Obstet

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Objective To evaluate the agreement between the histopathological diagnoses of preoperative endometrial samples and surgical specimens and correlate the agreement between the diagnoses with the impact on surgical management and the survival of patients with endometrial adenocarcinomas. Methods Sixty-two patients treated for endometrial cancer at a university hospital from 2002 to 2011 were retrospectively evaluated. The histopathological findings of preoperative endometrial samples and of surgical specimens were analyzed. The patients were subjected to hysterectomy as well as adjuvant treatment, if necessary, and clinical follow-up, according to the institutional protocol. Lesions were classified as endometrioid tumor (type 1) grades 1, 2, or 3 or non-endometrioid carcinoma (type 2). Results The agreement between the histopathological diagnoses based on preoperative endometrial samples and surgical specimens was fair (Kappa: 0.40; p < 0.001). However, the agreement was very significant for tumor type and grade, in which a higher concordance occurred at a higher grade. The percentage of patients with lymph nodes affected was 19.2%. Although most patients presenting with disease remission or cure were in the early stages (90.5%), there were no significant differences between those patients who had a misdiagnosis (11/16; 68.8%) and those who had a correct diagnosis (25/33; 75.8%) based on preoperative endometrial sampling (p = 0.605). Conclusion Our findings corroborate the literature and confirm the under staging of preoperative endometrial samples based on histopathological assessment, especially for lower grade endometrial tumors. We suggest that the preoperative diagnosis should be complemented with other methods to better plan the surgical management strategy.

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“…Such a study could accurately define the role and type of preoperative sampling methods. When data in this review (Table 1) were compared with meta-analyses by Van Hanegem et al (14), who analyzed the accuracy of endometrial sampling in women with postmenopausal bleeding, it was found that most studies suggest that more research on this subject using larger samples is needed, given the prevalence of EC and atypical hyperplasia (2,11,12,14,25,26,29). All of this could indicate that there is a need for more studies that will also account for power and sample size when comparing the performance of various methods.…”

Section: Discussionmentioning

confidence: 96%

“…The first step in diagnosis should be ultrasound measurement of endometrial thickness, using a cutoff point of 3 or 4 mm, followed by endometrial sampling (1,7). When planning the extent of EC surgery, it is necessary to be aware that the histology results of the preoperative biopsy and the final sample may differ in up to 15% to 25% of cases (12)(13)(14)(15)(16)(17), or even 32% to 97% of cases according to some sources (18)(19)(20). From this perspective, the histology and grade EC are one of the most important predicting factors of disease outcome and of the likelihood of nodal metastasis.…”

Section: E N D O M E T R I a L C A N C E R ( E C ) I S T H E M O S T C O M M O N Gynecological Malignancy In High-income Countries (1)mentioning

confidence: 99%

Accuracy of preoperative sampling diagnosis for predicting final pathology in patients with endometrial carcinoma: a review

Lukanović¹,

Matjašič²,

Kobal³

2020

Transl Cancer Res TCR

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Endometrial cancer (EC) is the most common gynecologic cancer. The most frequent symptom of this disease is postmenopausal bleeding. Diagnosis of EC must be histologically confirmed, and there are several methods for endometrial sampling to obtain cells or endometrial tissue. The first step in diagnosis should be ultrasound measurement of endometrial thickness, followed by endometrial sampling, which can be performed by office endometrial biopsy, hysteroscopic biopsy, or dilatation and curettage (D&C). The review in this article was carried out to present previously published studies, comprehensively evaluate method performance (i.e., overall accuracy of preoperative sampling in patients with endometrial carcinoma, and overall agreement on grade and histological subtype between preoperative endometrial sampling and final diagnosis), and determine which sampling method is most accurate on the basis of the statistical data in the studies analyzed. From the literature analyzed and examined, it can be concluded that preoperative endometrial sampling is not always the best predictor of final histology in EC and has its limitations. In surgical decisions based only on preoperative sampling, a biopsy should be made with caution, and it is necessary to take other parameters into account. Inadequate grading leads to suboptimal clinical management, mainly in early-stage tumors. This review showed that, although hysteroscopic biopsy was mainly associated with the highest tumor grade agreement, and although D&C showed the highest overall accuracy in detecting endometrial carcinoma, the data do not therefore reliably indicate which method yields the most precise results. The results of this review indicate that further studies on larger samples and with greater statistical power are needed to accurately define the role and type of preoperative sampling methods.

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Preoperative diagnosis of tumor grade and type in endometrial cancer by pipelle sampling and hysteroscopy: Results of a French study

Cited by 30 publications

References 27 publications

The Use of microRNAs in the Management of Endometrial Cancer: A Meta-Analysis

The Use of microRNAs in the Management of Endometrial Cancer: A Meta-Analysis

Assessment of Preoperative Endometrial Histopathological Sampling as a Predictor of Final Surgical Pathology in Endometrial Cancer

Accuracy of preoperative sampling diagnosis for predicting final pathology in patients with endometrial carcinoma: a review

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