Concordance between preoperative ESMO-ESGO-ESTRO risk classification and final histology in early-stage endometrial cancer.
Biopsy
Cancer Staging
Endometrial Cancer
Magnetic Resonance Imaging
Risk Assessment
Sentinel Lymph Node
Journal
Journal of gynecologic oncology
ISSN: 2005-0399
Titre abrégé: J Gynecol Oncol
Pays: Korea (South)
ID NLM: 101483150
Informations de publication
Date de publication:
07 2021
07 2021
Historique:
received:
17
12
2020
revised:
22
01
2021
accepted:
06
02
2021
pubmed:
29
4
2021
medline:
25
2
2023
entrez:
28
4
2021
Statut:
ppublish
Résumé
To evaluate the concordance between preoperative European Society for Medical Oncology (ESMO)-European Society of Gynaecological Oncology (ESGO)-European SocieTy for Radiotherapy and Oncology (ESTRO) risk classification in early-stage endometrial cancer (EC) assessed by biopsy and magnetic resonance imaging (MRI) with this classification based on histology of surgical specimen. This bicentric retrospective study included women diagnosed with early-stage EC (≤stage II) who had a complete preoperative assessment and underwent a surgical management from January 2011 to December 2018. Patients were preoperatively classified into 3 degrees of risk of lymph node (LN) involvement based on biopsy and MRI. Based on final histological report, patients were re-classified using the preoperative classification. Concordance between the preoperative assessment and definitive histology was calculated with weighted Cohen's kappa coefficient. A total of 333 women were included and kappa coefficient of preoperative risk classification was 0.49. The risk was underestimated and overestimated in 37% and 10% of cases, respectively. Twenty-nine percent of patients had an incomplete LN staging according to the degree of risk of re-classification. The observed discordance in the risk classification was attributed to MRI in 75% of cases, to biopsy in 18% and in 7% to both (p<0.001). Kappa coefficient for concordance was 0.25 for MRI and 0.73 for biopsy. Concordance between preoperative ESMO-ESGO-ESTRO risk classification and final histology is weak. Given that the risk was underestimated in the majority of patients wrongly classified, sentinel LN procedure instead of no LN dissection could be an option offered to preoperative low-risk patients to decrease the indication of second surgery for re-staging and/or to avoid toxicity of adjuvant radiotherapy.
Identifiants
pubmed: 33908709
pii: 32.e48
doi: 10.3802/jgo.2021.32.e48
pmc: PMC8192240
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
e48Commentaires et corrections
Type : CommentIn
Informations de copyright
Copyright © 2021. Asian Society of Gynecologic Oncology, Korean Society of Gynecologic Oncology, and Japan Society of Gynecologic Oncology.
Déclaration de conflit d'intérêts
No potential conflict of interest relevant to this article was reported.
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