Evaluating the diagnostic performance of preoperative endometrial biopsies in patients diagnosed with high grade endometrial cancer: A study of the Society of Gynecologic Oncology (GOC) Community of Practice (CoP)

• Published in: Gynecologic oncology 2020-10, Vol.159 (1), p.52-57
• Main Authors: Jegatheeswaran, Kizanee, Cormier, Beatrice, Dube, Samantha, Gotlieb, Walter Henri, Helpman, Limor, Kwon, Janice S., Lau, Susie, Mah, Sarah, May, Taymaa, Saab, Dima, McNeill, Maggie, Plante, Marie, Renaud, Marie Claude, Shamiya, Sarah, Vicus, Danielle, Parra-Herran, Carlos, Feigenberg, Tomer
• Format: Article
• Language: English
• Subjects: Aged; Biopsy - statistics & numerical data; Canada - epidemiology; Chemoradiotherapy, Adjuvant; Endometrial biopsy; Endometrial cancer; Endometrial Neoplasms - diagnosis; Endometrial Neoplasms - pathology; Endometrial Neoplasms - therapy; Endometrium - pathology; Endometrium - surgery; Female; Humans; Hysterectomy; Middle Aged; Neoplasm Grading - methods; Neoplasm Grading - statistics & numerical data; Neoplasm Recurrence, Local - epidemiology; Neoplasm Recurrence, Local - prevention & control; Neoplasm Staging - methods; Neoplasm Staging - statistics & numerical data; Pathology; Predictive Value of Tests; Preoperative Period; Retrospective Studies; Risk Assessment - methods; Risk Assessment - statistics & numerical data; Surgical staging
• ISSN: 0090-8258; 1095-6859
• DOI: 10.1016/j.ygyno.2020.06.510

High grade cancers account for a disproportionate number of recurrences in patients with endometrial cancer. Accurately identifying these cases on endometrial biopsies allows for better surgical planning. This study evaluates the diagnostic accuracy of general pathologists (GP) compared to gynecological pathologists (GYNP) in interpreting preoperative biopsies. A retrospective cohort study was conducted of patients diagnosed with high grade endometrial cancer (HGEC) between 2012 and 2016 at eight Canadian cancer centres. Data was collected from medical records. Pre-operative biopsies were categorized into groups; biopsies read by GP, GYNP and GP reviewed by GYNP. Rates of HGEC on pre-operative biopsy were calculated. Fisher exact test was used to compare differences between the groups. Univariate logistic regression analysis was conducted for HGEC prediction. Of 1237 patients diagnosed with HGEC, 245 (19.8%) did not have a preoperative diagnosis of high-grade disease. Discordancy was identified in 91/287 (31.71%) of biopsies reported by GP, and in 114/910 (12.53%) of biopsies reported by a GYNP (p