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Submitted: 16 May 2007 Modified: 10 September 2019
HERDIN Record #: PCHRDPC030468

The accuracy of the preoperative endometrial biopsy in predicting final histopathologic grade in endometrial adenocarcinoma.

 Luna, Jericho Thadde,
 Carnate, Jose M Jr,
 Victoriano-Germar, M

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OBJECTIVE: To determine the accuracy of the preoperative endometrial biopsy in predicting the final histopathologic grade in endometrial adenocarcinoma.

METHODS: All patients diagnosed with endometrial adenocarcinoma from January 1995 to September 2002 who had their preoperative endometrial biopsy done at a tertiary institution were included. The slides of both the preoperative biopsy and hysterectomy specimen were retrieved and reviewed by a single pathologist as to the tumor grade.

RESULTS: The tumor grade was accurately determined by preoperative biopsy in 72 out of the 132 cases (54.5 percent). Sixty patients (42 percent) were either upgraded (n=31,23.5 percent) or downgraded (n=29.22 percent) at hysterectomy. Individual tumor grades were accurately determined in grade 1, 2 and 3 tumors in 28 of 51 (54.9 percent), 22 of 43 (51.2 percent) and 22 of 38 (57.89 percent) patients respectively. Poorly differentiated tumors were overdiagnosed in 16 (42.1 percent) cases and missed in 16 (42.1 percent) cases. When Grade 1 disease was diagnosed by curettage, hysterectomy subsequently demonstrated grade 3 tumor in 8 (18.6 percent) cases.

CONCLUSION: The inacurracy of preoperative assessment of tumor grade in determining the final histopathologic grade in endometrial adenocarcinoma and the potential therapeutic benefit of lymph node dissection make intraoperative decision based lymph node dissection difficult to apply prospectively with certainty. Therefore, complete surgical staging to gather full pathologic and prognostic data should be advocated for all women diagnosed with endometrial adenocarcinoma who do not have medical or technical contraindications to lymph node dissection. (Author)

Publication Type
Publication Sub Type
Philippine Journal of Obstetrics and Gynecology
Publication Date
September- 2003
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Philippine Council for Health Research and Development Library Fulltext pdf (Request Document)

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