Comparison of D&C and office endometrial biopsy in predicting final histopathologic grade in endometrial cancer.
OBJECTIVE
To compare the accuracy of D&C and office Z-sampler endometrial biopsy in predicting hysterectomy tumor grade in women with endometrial cancer.


METHODS
Between September 1987 and July 1994, 183 women with endometrial cancer had D&C or office Z-sampler endometrial biopsy before hysterectomy.


RESULTS
One hundred thirty-one patients (72%) had Z-sampler biopsies and 52 (28%) had D&C. The Z-sampler correctly identified the hysterectomy tumor grade in 76 of 131 patients (58%), compared with 40 of 52 (77%) with D&C, a significant difference (P = .024). The major difference observed was an increased fraction of lesions undergraded (ie, a lower grade tumor found in the biopsy than in the hysterectomy specimen) by the Z-sampler (34 of 131, 26%) versus D&C (five of 52, 10%).


CONCLUSIONS
Dilation and curettage was more accurate in identifying hysterectomy tumor grade and less likely to miss a higher-grade tumor than was Z-sampler biopsy. However, the inaccuracy of D&C alone necessitates further preoperative and intraoperative assessment for other risk factors to determine the aggressiveness with which an individual patient should be staged surgically.
Larson
D M
DM
Department of Obstetrics and Gynecology, Marshfield Clinic, Wisconsin, USA.
Johnson
K K
KK
Broste
S K
SK
Krawisz
B R
BR
Kresl
J J
JJ
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000556:Ambulatory Surgical Procedures; D001706:Biopsy; D004107:Dilatation and Curettage; D016889:Endometrial Neoplasms / Q000473:pathology* / Q000601:surgery; D005260:Female; D006801:Humans; D007044:Hysterectomy; D008875:Middle Aged; D011237:Predictive Value of Tests; D011300:Preoperative Care; D015203:Reproducibility of Results; D012189:Retrospective Studies