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The amount of preoperative endometrial tissue surface in relation to final endometrial cancer classification
SW. Vrede, AMC. Hulsman, C. Reijnen, K. Van de Vijver, E. Colas, G. Mancebo, CP. Moiola, A. Gil-Moreno, J. Huvila, M. Koskas, V. Weinberger, L. Minar, E. Jandakova, M. Santacana, X. Matias-Guiu, F. Amant, MPLM. Snijders, HVN. Küsters-Vandevelde,...
Language English Country United States
Document type Journal Article
- MeSH
- Biopsy methods MeSH
- Endometrium pathology MeSH
- Carcinoma, Endometrioid * surgery pathology MeSH
- Humans MeSH
- Endometrial Neoplasms * pathology MeSH
- Retrospective Studies MeSH
- Check Tag
- Humans MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
OBJECTIVE: To evaluate whether the amount of preoperative endometrial tissue surface is related to the degree of concordance with final low- and high-grade endometrial cancer (EC). In addition, to determine whether discordance is influenced by sampling method and impacts outcome. METHODS: A retrospective cohort study within the European Network for Individualized Treatment of Endometrial Cancer (ENITEC). Surface of preoperative endometrial tissue samples was digitally calculated using ImageJ. Tumor samples were classified into low-grade (grade 1-2 endometrioid EC (EEC)) and high-grade (grade 3 EEC + non-endometroid EC). RESULTS: The study cohort included 573 tumor samples. Overall concordance between pre- and postoperative diagnosis was 60.0%, and 88.8% when classified into low- and high-grade EC. Upgrading (preoperative low-grade, postoperative high-grade EC) was found in 7.8% and downgrading (preoperative high-grade, postoperative low-grade EC) in 26.7%. The median endometrial tissue surface was significantly lower in concordant diagnoses when compared to discordant diagnoses, respectively 18.7 mm2 and 23.5 mm2 (P = 0.022). Sampling method did not influence the concordance in tumor classification. Patients with preoperative high-grade and postoperative low-grade showed significant lower DSS compared to patients with concordant low-grade EC (P = 0.039). CONCLUSION: The amount of preoperative endometrial tissue surface was inversely related to the degree of concordance with final tumor low- and high-grade. Obtaining higher amount of preoperative endometrial tissue surface does not increase the concordance between pre- and postoperative low- and high-grade diagnosis in EC. Awareness of clinically relevant down- and upgrading is crucial to reduce subsequent over- or undertreatment with impact on outcome.
Department of Obstetrics and Gynaecology Canisius Wilhelmina Hospital Nijmegen the Netherlands
Department of Obstetrics and Gynaecology Hosepital del Mar PSMAR Barcelona Spain
Department of Obstetrics and Gynaecology Radboud university medical center Nijmegen the Netherlands
Department of Oncology KU Leuven Leuven Belgium
Department of Pathology Canisius Wilhelmina Hospital Nijmegen the Netherlands
Department of Pathology Ghent University Hospital Cancer Research Institute Ghent Ghent Belgium
Department of Pathology Radboud University Medical Centre Nijmegen the Netherlands
Department of Pathology University of Turku Turku Finland
Department of Radiation Oncology Radboud university medical center Nijmegen the Netherlands
Gynaecological Department Vall d'Hebron University Hospital CIBERONC Barcelona Spain
Obstetrics and Gynaecology Department Bichat Claude Bernard Hospital Paris France
Pathology Department Vall d'Hebron University Hospital CIBERONC Barcelona Spain
References provided by Crossref.org
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- $a Vrede, S W $u Department of Obstetrics and Gynaecology, Radboud university medical center, Nijmegen, the Netherlands; Department of Obstetrics and Gynaecology, Canisius-Wilhelmina Hospital, Nijmegen, the Netherlands. Electronic address: stephanie.vrede@radboudumc.nl
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- $a The amount of preoperative endometrial tissue surface in relation to final endometrial cancer classification / $c SW. Vrede, AMC. Hulsman, C. Reijnen, K. Van de Vijver, E. Colas, G. Mancebo, CP. Moiola, A. Gil-Moreno, J. Huvila, M. Koskas, V. Weinberger, L. Minar, E. Jandakova, M. Santacana, X. Matias-Guiu, F. Amant, MPLM. Snijders, HVN. Küsters-Vandevelde, ENITEC-consortium, J. Bulten, JMA. Pijnenborg
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- $a OBJECTIVE: To evaluate whether the amount of preoperative endometrial tissue surface is related to the degree of concordance with final low- and high-grade endometrial cancer (EC). In addition, to determine whether discordance is influenced by sampling method and impacts outcome. METHODS: A retrospective cohort study within the European Network for Individualized Treatment of Endometrial Cancer (ENITEC). Surface of preoperative endometrial tissue samples was digitally calculated using ImageJ. Tumor samples were classified into low-grade (grade 1-2 endometrioid EC (EEC)) and high-grade (grade 3 EEC + non-endometroid EC). RESULTS: The study cohort included 573 tumor samples. Overall concordance between pre- and postoperative diagnosis was 60.0%, and 88.8% when classified into low- and high-grade EC. Upgrading (preoperative low-grade, postoperative high-grade EC) was found in 7.8% and downgrading (preoperative high-grade, postoperative low-grade EC) in 26.7%. The median endometrial tissue surface was significantly lower in concordant diagnoses when compared to discordant diagnoses, respectively 18.7 mm2 and 23.5 mm2 (P = 0.022). Sampling method did not influence the concordance in tumor classification. Patients with preoperative high-grade and postoperative low-grade showed significant lower DSS compared to patients with concordant low-grade EC (P = 0.039). CONCLUSION: The amount of preoperative endometrial tissue surface was inversely related to the degree of concordance with final tumor low- and high-grade. Obtaining higher amount of preoperative endometrial tissue surface does not increase the concordance between pre- and postoperative low- and high-grade diagnosis in EC. Awareness of clinically relevant down- and upgrading is crucial to reduce subsequent over- or undertreatment with impact on outcome.
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