The pre-operative identification of low-risk endometrialcancer: an audit of women treated in the South Island of New Zealand 1998-2000

• Published in: Australian & New Zealand journal of obstetrics & gynaecology 2002-10, Vol.42 (4), p.387-390
• Main Authors: Sykes, P, Nam, S, Wynne, C, Anderson, N, North, J, Hunter, L, Laney, M, Fentiman, G
• Format: Article
• Language: English
• Subjects: Curettage - standards; Endometrial Neoplasms - diagnosis; Endometrial Neoplasms - diagnostic imaging; Endometrial Neoplasms - pathology; Female; Gynecology - standards; Humans; Lymphatic Metastasis; Medical Audit; Medical Records; New Zealand; Practice Guidelines as Topic; Predictive Value of Tests; Preoperative Care - standards; Prognosis; Retrospective Studies; Ultrasonography
• ISSN: 0004-8666

To determine whether pre-operative investigations identify a group of patients with low-risk endometrial cancer, who do not require tertiary referral for surgical staging or pelvic radiotherapy. Retrospective chart review. South Island of New Zealand gynaecological oncology services. One hundred and forty consecutive patients with newly diagnosed endometrial cancer from 1988 to 2000. The results of preoperative investigations were compared with the final pathology. Correlation of preoperative investigations with low risk disease. For the purpose of the study, women with grade 1 or 2 endometrioid tumours confined to the uterine body and less than 50% myometrial invasion were considered to have low risk disease. In total, 50 women had low risk disease. Only 53% of patients with grade 1 tumours on initial biopsy had low risk disease. Women who had a grade 1 tumour at biopsy and, an ultrasound report with an endometrial thickness of less than 20 mm, and no evidence of myometrial invasion, cervical involvement or adnexal metastasis had a 76% chance of having low risk disease. We were unable to accurately define the low risk group from pre-operative assessment.