Discrepancy between preoperative endometrial sampling and hysterectomy diagnosis in endometrial cancer

Authors

Keywords:

endometrial cancer, endometrial sampling versus hysterectomy diagnosis

Abstract

Background: A study was conducted to determine the accuracy of preoperative endometrial sampling histology type and tumour grade results compared with the final postoperative diagnosis.

Methods: This was a retrospective chart audit of patients with endometrial cancer and atypical hyperplasia admitted to Grey’s Hospital in Pietermaritzburg, South Africa, from January 2013 to December 2017.

Results: Sixty patients met the inclusion criteria. For endometrial cancer histological types, the accuracy of preoperative endometrial sampling was 94.7% (36/38) for endometrioid adenocarcinoma, 42.9% (3/7) for serous papillary carcinoma, 85.7% (6/7) for carcinosarcoma and 75% (9/12) for atypical hyperplasia. A kappa value of 0.825 was obtained with a p-value of 0.000 for agreement between preoperative endometrial sampling and the final postoperative diagnosis. For endometrioid adenocarcinoma tumour grading 1–3 (G1–3), only 16/38 (42.1%) patients met the criteria to compare the pre- and postoperative results, which were as follows: of the eight patients with grade 1 tumour on preoperative sampling one patient (1.25%) was upgraded to grade 2 tumour postoperatively. There were no changes in tumour grading for grade 2 and 3 tumours, 3/3 and 5/5 respectively.

Conclusion: Our study results for endometrioid adenocarcinoma are comparable to previous literature. However, there were significant discrepancies for non-endometrioid adenocarcinoma. Deficiencies that need to be addressed by laboratories in order to improve both preoperative surgical staging and postoperative adjuvant therapy planning were also highlighted.

Author Biographies

  • S E Mhlongo, Universiteit van KwaZulu-Natal

    Department of Obstetrics and Gynaecology, Grey’s Hospital, University of KwaZulu-Natal, Pietermaritzburg, South Africa

  • T D Naidoo, Universiteit van KwaZulu-Natal

    Department of Obstetrics and Gynaecology, Grey’s Hospital, University of KwaZulu-Natal, Pietermaritzburg, South Africa

  • B S Makhathini, Universiteit van KwaZulu-Natal

    Department of Obstetrics and Gynaecology, Grey’s Hospital, University of KwaZulu-Natal, Pietermaritzburg and Gynaecologic Oncology Unit, Department of Obstetrics and Gynaecology, University of Pretoria, Pretoria, South Africa

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Published

2020-12-15

Issue

Vol. 12 No. 1 (2020)

Section

Original Research

License

South African Journal of Gynaecological Oncology (SAJGO) Copyright is held by South African Society of Gynaecologic Oncology (SASGO). Copyright of the articles is held by the authors. The work is licensed under a Creative Commons Attribution-Non-Commercial Works 4.0 South Africa License (CC BY NC). Material submitted for publication in the SAJGO is accepted provided it has not been published elsewhere. The SAJGO does not hold itself responsible for statements made by the authors. The opinions expressed in this publication are those of the authors. They do no purport to reflect the opinions or views of SASGO or its members.