Comparison of D&C and office endometrial biopsy accuracy in patients with FIGO grade 1 endometrial adenocarcinoma Journal Article

Authors: Leitao, M. M. Jr; Kehoe, S.; Barakat, R. R.; Alektiar, K.; Gattoc, L. P.; Rabbitt, C.; Chi, D. S.; Soslow, R. A.; Abu-Rustum, N. R.
Article Title: Comparison of D&C and office endometrial biopsy accuracy in patients with FIGO grade 1 endometrial adenocarcinoma
Abstract: Objective: To compare the accuracy of D&C vs office endometrial biopsy in predicting final post-hysterectomy FIGO grade in patients diagnosed with a preoperative FIGO grade 1 endometrial adenocarcinoma. Methods: We reviewed 1423 consecutive cases of endometrial cancer treated at our institution between 1/1/93 and 5/31/06 and identified cases with an unequivocal preoperative endometrial biopsy demonstrating FIGO grade 1 endometrial adenocarcinoma. All cases were pathologically confirmed and underwent surgical therapy at our institution. FIGO grade and histology diagnosed in the hysterectomy specimen were noted. The findings in the hysterectomy specimen were then compared between those patients who had a preoperative D&C vs an office endometrial sampling. Chi-square and Fisher-exact test were used as appropriate. Results: We identified 490 cases with a preoperative FIGO grade 1 endometrial adenocarcinoma. In 482 cases, FIGO grade was determined to be greater in 71 (14.7%) cases; in the final hysterectomy specimen, 66 (13.7%) were found to be grade 2 and 5 (1%) were found to be grades 2-3/3. Serous or clear cell histology was diagnosed in 6 (1.2%) additional cases. D&C was performed in 187 (38.6%) cases and office endometrial sampling in 298 (61.4%); in 5 cases the method used was not discernible. The final post-hysterectomy FIGO grade was higher in 16/187 (8.7%) cases diagnosed by D&C compared to 52/298 (17.4%) diagnosed by office endometrial sampling (P = 0.007). Conclusions: Preoperative FIGO grade 1 diagnosis correlates with final grade diagnosis in 85% of cases. While D&C more accurately reflects final FIGO grade, a higher grade will be found in 8.7% of the cases at the time of hysterectomy. © 2008 Elsevier Inc. All rights reserved.
Keywords: adult; controlled study; human tissue; aged; aged, 80 and over; middle aged; human cell; major clinical study; endometrial cancer; endometrium carcinoma; hysterectomy; endometrial neoplasms; cancer grading; diagnostic accuracy; preoperative evaluation; adenocarcinoma; medical record review; biopsy; histology; tissue section; disease severity; diagnostic value; intermethod comparison; d&c; endometrial biopsy; curettage; endometrium; endometrium biopsy; dilatation and curettage
Journal Title: Gynecologic Oncology
Volume: 113
Issue: 1
ISSN: 0090-8258
Publisher: Elsevier Inc.  
Date Published: 2009-04-01
Start Page: 105
End Page: 108
Language: English
DOI: 10.1016/j.ygyno.2008.12.017
PUBMED: 19167049
PROVIDER: scopus
Notes: --- - "Cited By (since 1996): 3" - "Export Date: 30 November 2010" - "CODEN: GYNOA" - "Source: Scopus"
Citation Impact
MSK Authors
  1. Richard R Barakat
    629 Barakat
  2. Dennis S Chi
    596 Chi
  3. Kaled M Alektiar
    287 Alektiar
  4. Mario Leitao
    442 Leitao
  5. Siobhan Marie Kehoe
    22 Kehoe
  6. Robert Soslow
    754 Soslow
  7. Catherine Anne McKeon
    8 McKeon