Publication:

A clinical comparative study of preoperative clinical staging and surgical and histopathological staging in endometrial carcinoma

Background Endometrial cancer is the fourth most common carcinoma in women across the globe. Treatment and prognosis are influenced by surgical international federation of gynecology and obstetrics staging system with evaluation of the depth of myometrium invasion, cervical extension and the presence of lymph node and distant metastasis. This study aims to compare the MRI findings in preoperative staging of endometrial carcinoma with intra-operative findings and revised international federation of gynecology and obstetrics staging based on postoperative histopathology.

Methods The study was prospectively carried out in department of obstetrics and gynecology of a Cama Hospital, Mumbai for a total period of 1.5 years; 30 patients diagnosed with endometrial carcinoma were selected.

Results The patients were predominantly multiparous with most common presenting complaint as postmenopausal bleeding. The clinical- radiological staging was concordant with histopathological staging in 60% (18/30) cases. Upstaging was seen in 10% (3/30 cases), while 30% (9/30) showed down staging in the final histopathology. While comparing the surgical intra-operative staging, it was seen to corroborate with the final histopathology in 63.33% (19/30) cases.

Conclusions The pre-operative radiological assessment especially MRI with high accuracy in determining myometrial invasion is an inseparable tool. The surgeon would have to rely on intra-operative assessment for further plan of action and effectively dealing with carcinoma.