OBJECTIVE METHODS FOR ASSESSMENT OF DEEP MYOMETRIAL AND CERVICAL INVASION IN PATIENTS WITH ENDOMETRIAL CANCER
Journal
Medicus
Date Issued
2023-12
Author(s)
Stojchevski, Sasho
Abstract
Introduction: Endometrial cancer is the most common gynaecological malignancy. This study analyzed different objective methods with transvaginal ultrasonography for the assessment of deep myometrial and cervical invasion in patients with endometrial cancer to choose the optimal surgical treatment.
Material and methods: It represents a prospective cohort study in which 45 patients with a histological diagnosis of endometrial cancer were analyzed. They are examined with transvaginal ultrasound to assess deep myometrial and cervical invasion.
Results: Objective parameters such as those of Gordon result in a sensitivity of 76% and a specificity of 85% and Carlson with a sensitivity of 72% and specificity 95%. 3D ultrasonography resulted in a sensitivity of 92% and a specificity of 78%. The objective assessment of cervical tumour invasion below the OUI (internal uterine orificum) had a sensitivity of 70% and a specificity of 85%, and the one with a cut-off <20.5mm distance from the OUE (external uterine orificium) to the lower margin of the tumour had a sensitivity of 86% and specificity 75%.
Discussion: The therapeutic modality in patients with endometrial cancer depends on several factors such as histological type, nuclear grade, myometrial and cervical invasion, which, if present, require radical surgical treatment and the need for evaluation of lymph nodes for appropriate surgical staging.
Conclusion: The obtained results are comparable with relevant works on this issue. Transvaginal ultrasonography is similarly effective to nuclear magnetic resonance for assessing deep myometrial and cervical invasion.
Material and methods: It represents a prospective cohort study in which 45 patients with a histological diagnosis of endometrial cancer were analyzed. They are examined with transvaginal ultrasound to assess deep myometrial and cervical invasion.
Results: Objective parameters such as those of Gordon result in a sensitivity of 76% and a specificity of 85% and Carlson with a sensitivity of 72% and specificity 95%. 3D ultrasonography resulted in a sensitivity of 92% and a specificity of 78%. The objective assessment of cervical tumour invasion below the OUI (internal uterine orificum) had a sensitivity of 70% and a specificity of 85%, and the one with a cut-off <20.5mm distance from the OUE (external uterine orificium) to the lower margin of the tumour had a sensitivity of 86% and specificity 75%.
Discussion: The therapeutic modality in patients with endometrial cancer depends on several factors such as histological type, nuclear grade, myometrial and cervical invasion, which, if present, require radical surgical treatment and the need for evaluation of lymph nodes for appropriate surgical staging.
Conclusion: The obtained results are comparable with relevant works on this issue. Transvaginal ultrasonography is similarly effective to nuclear magnetic resonance for assessing deep myometrial and cervical invasion.
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