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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.
Role of concurrent transcervical resection and curettage (TCR+C) in detecting endometrial cancer
K. Nagasaka1, *, Y. Matsumoto1, K. Oda1, M. Maruyama2, M. Ikemura3, T. Arimoto1, K. Kawana1, M. Fukayama3, Y. Osuga1, T. Fujii1, Gynecologic Oncology Group1, Endoscopic Surgery Group1
1 Department of Obstetrics and Gynecology, Faculty of Medicine, The University of Tokyo, Tokyo, Japan
2 Department of Obstetrics and Gynecology, Maruyama Memorial General hospital, Saitama, Japan
3 Department of Pathology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
Eur. J. Gynaecol. Oncol. 2018, 39(2), 265–270; https://doi.org/10.12892/ejgo3931.2018
Published: 10 April 2018
Objectives: The aim of this study was to evaluate the usefulness of concurrent transcervical resection and total curettage (TCR+C) for patients in whom a definitive preoperative pathological diagnosis of the presence or absence of endometrial cancer (EC) could not be obtained. Materials and Methods: A total of 125 patients who underwent curettage with office hysteroscopy (63 patients) or TCR+C (62 patients) for suspected uterine malignancy were retrospectively reviewed by focusing on pathologic and hysteroscopic findings. Furthermore, the pathological diagnostic accuracies of EC between curettage alone and TCR+C were analyzed in 29 EC patients who received hysterectomy. Results: Six of 12 suspected EC patients (50%) who underwent curettage alone had a discrepancy in the final diagnosis by hysterectomy; meanwhile, 15 of 17 suspected EC patients (88.2%) were accurately diagnosed as EC by TCR+C before hysterectomy. In total, TCR+C provided significantly more accurate pathological diagnosis of EC than curettage alone with office hysteroscopy (p = 0.038 by Fisher’s exact test). In addition, hysteroscopic findings showed that all resected specimens of white desquamation lesions with atypical branched vessels in the endometrium were diagnosed as endometrial cancer. No significant adverse effect was observed in TCR+C group. Conclusions: Endometrial diagnosis with TCR+C is a more useful technique for suspected EC lesions than curettage alone.