Preoperative and postoperative histologic grade in endometrial cancer: correlation with myometrial invasion

Authors : Işıl Turan Bakırcı, Gökhan Bolluk, Ceyhun Numanoğlu, Ahmet Gülkılık
Pages : 143-147
Doi:10.47582/jompac.1648365
View : 35 | Download : 33
Publication Date : 2025-03-23
Article Type : Research Paper
Abstract :Aims: Preoperative tumor histologic evaluation plays a crucial role in determining the surgical and therapeutic approach for endometrial cancer. However, discrepancies between preoperative and postoperative histopathological findings are common, potentially affecting clinical management. Methods: This retrospective study included 287 patients diagnosed with endometrial cancer at Bakırköy Maternity and Children Training and Research Hospital. All patients underwent preoperative fractional dilatation and curettage (D&C) followed by total abdominal hysterectomy with or without lymphadenectomy. Preoperative and postoperative pathology reports were compared to assess concordance in tumor grade and histological subtype. The correlation between grade agreement and myometrial invasion was also analyzed. Results: The histologic type changed in 17.6% of cases between preoperative curettage and postoperative hysterectomy. The tumor grade was upgraded in 50.7% of grade 1 cases and 11.6% of grade 2 cases. The overall concordance between the preoperative and postoperative tumor grading was weak (kappa=0.292, p<0.001). The grade agreement was higher in cases with deep myometrial invasion (kappa=0.32) than in those with superficial invasion (kappa=0.24). Conclusion: The substantial rate of discordance between preoperative and postoperative histologic findings highlights the limitations of D&C in accurately predicting tumor grade. Given the impact of tumor grading on surgical and adjuvant treatment decisions, multimodal preoperative assessment integrating imaging and molecular profiling may improve diagnostic accuracy and optimize treatment strategies for endometrial cancer.
Keywords : Endometriyal kanser, tümör derecesi, histolojik uyum, myometriyal invazyon, dilatasyon ve küretaj.

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