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European Journal of Gynaecological Oncology (EJGO) is published by IMR Press from Volume 40 Issue 1 (2019). Previous articles were published by another publisher on a subscription basis, and they are hosted by IMR Press on imrpress.com as a courtesy and upon agreement with S.O.G.
Original Research
Assessment of different pre- and intra-operative strategies to predict the actual ESMO risk group and to establish the appropriate indication of lymphadenectomy in endometrial cancer
S. Vieillefosse1, C. Huchon2, 3, F. Chamming's4, M.A. Le Frère-Belda5, L. Fournier4, 6, C. Ngô1, 6, 7, F. Lécuru1, 6, 7, A.S. Bats1, 6, 7
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1
Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges-Pompidou, Chirurgie Cancérologique Gynécologique et du Sein, Paris, France
2
Centre Hospitalier Intercommunal de Poissy Saint Germain, Service de Gynécologie-Obstétrique, Paris, France
3
EA 7285, Risques Cliniques et Sécurité en Santé des Femmes, Université Versailles Saint Quentin en Yvelines, Faculté de Médecine, Paris, France
4
Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges-Pompidou, Imagerie, Paris, France
5
Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges-Pompidou, Anatomopathologie, Paris, France
6
Université Paris Descartes, Sorbonne Paris Cité, Faculté de Médecine, Paris, France
7
INSERM UMR-S 1124, Université Paris Descartes, Paris, France
Eur. J. Gynaecol. Oncol. 2018, 39(1), 19–26;
https://doi.org/10.12892/ejgo3581.2018
Published: 10 February 2018
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: 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: 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 two 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. Conclusion: The present 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.
Keywords
Endometrial cancer
Lymphadenectomy
Ultrasound
MRI
Intra-operative examination