Diagnostic accuracy of preoperative tests for lymph node status in endometrial cancer: a systematic review

Approximately 72% of endometrial cancers are FIGO stage I at diagnosis and about 10% have lymph node metastases. An ideal diagnostic test for nodal disease would be able to prevent both overtreatment (i.e. unnecessary lymphadenectomy) and undertreatment (i.e. withholding lymphadenectomy or adjuvant...

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Bibliographic Details
Published in:Cancer imaging 2013-01, Vol.13 (3), p.314-322
Main Authors: Pelikan, H M P, Trum, J W, Bakers, F C H, Beets-Tan, R G H, Smits, L J M, Kruitwagen, R F P M
Format: Article
Language:English
Subjects:
CA-125 Antigen - blood
Endometrial Neoplasms - diagnosis
Endometrial Neoplasms - pathology
Female
Humans
Lymphatic Metastasis
Magnetic Resonance Imaging
Positron-Emission Tomography
Review
Tomography, X-Ray Computed
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Summary:Approximately 72% of endometrial cancers are FIGO stage I at diagnosis and about 10% have lymph node metastases. An ideal diagnostic test for nodal disease would be able to prevent both overtreatment (i.e. unnecessary lymphadenectomy) and undertreatment (i.e. withholding lymphadenectomy or adjuvant postoperative treatment to patients with lymph node metastases). In this review we compare the accuracy of preoperative tests (computed tomography, magnetic resonance imaging, positron emission tomography-computed tomography, CA-125 serum levels, and ultrasonography) for the detection of lymph node metastases in endometrial cancers with the final histopathologic diagnosis after complete pelvic and para-aortic lymphadenectomy as the gold standard. A systematic search in MEDLINE (using PubMed), Embase and The Cochrane Library was performed up to 23 July 2012. We found one article that met our inclusion criteria for computed tomography, none for magnetic resonance imaging, 2 for positron emission tomography/computed tomography), 2 for CA-125 and none for ultrasonography. Due to the lack of high-quality articles on a preoperative test for lymph node status in endometrial cancer, no proper comparison between these modalities can be made.
ISSN:1470-7330
1740-5025
1470-7330
DOI:10.1102/1470-7330.2013.0032