SUBJECTIVE METHODS FOR ASSESSMENT OF DEEP MYOMETRIAL AND CERVICAL INVASION IN PATIENTS WITH ENDOMETRIAL CANCER WITH TRANSVAGINAL ULTRASOUND

Abstract

Introduction: Endometrial cancer is the most common gynecological malignancy. In this study, the diagnostic accuracy of subjective methods with transvaginal ultrasonography for the assessment of deep myometrial and cervical invasion in patients with endometrial cancer was analyzed in order 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 with subjective methods based on IETA (International Endometrial Tumor Analysis) terminology. Results: Subjective assessment of deep myometrial invasion based on the International Endometrial Tumor Analysis (IETA) endometrial cancer terminology yielded a sensitivity of 88% and a specificity of 65%. Subjective assessment of deep myometrial invasion includes tumor echogenicity, endometrial-myometrial junction, color Doppler result and vascular pattern.Subjective assessment of cervical invasion includes loss of clear demarcation of tumor tissue from the cervical stroma and in the presence of stronger perfusion. Our subjective assessment of cervical invasion had a sensitivity of 76% and a specificity of 92%. The obtained results are comparable with relevant works on this issue. Conclusion: Transvaginal ultrasonography is similarly effective to nuclear magnetic resonance for assessing deep myometrial and cervical invasion; therefore, it can be used as a preoperative triage diagnostic tool to choose a surgical modality from which the mostly poor surgical candidate patients would benefit.