Intraoperative assessment of depth of myometrial invasion in endometrial carcinoma.
OBJECTIVE
To evaluate the adequacy of intraoperative assessment of depth of myometrial invasion in patients with endometrial adenocarcinoma.


METHODS
Of the 58 evaluable cases, depth of myometrial invasion was estimated by gross examination of fresh tissue by an experienced surgeon and a pathologist and on the frozen section by the same pathologist. This was compared with the depth of invasion on the final microscopic examination performed by another pathologist.


RESULTS
The depth of invasion was accurately predicted by the surgeon in 89.7% of the patients, while the pathologist's accurate prediction rates on fresh tissue and frozen section were 86.2% and 91.4%, respectively. The accurate prediction rate gradually diminished for both the surgeon and the pathologist as the histologic grade increased. Frozen section examination was reliable in grade I cancer (100%), while gross examination of the surgeon and the pathologist had a significant error rate in predicting accurate depth of invasion (7.6%-33%).


CONCLUSIONS
If frozen section shows that myometrial invasion in patients with grade 1 endometrial carcinoma is less than 1/3, lymphadenectomy may be omitted. In all other cases radical surgery and surgical staging is mandatory to avoid undertreatment.
Altintas
A
A
Department of Obstetrics and Gynecology, Cukurova University Medical Faculty, Adana, Turkey.
Cosar
E
E
Vardar
M A
MA
Demir
C
C
Tuncer
I
I
D000230:Adenocarcinoma / Q000473:pathology* / Q000601:surgery; D016889:Endometrial Neoplasms / Q000473:pathology* / Q000601:surgery; D005069:Evaluation Studies as Topic; D005260:Female; D006801:Humans; D007432:Intraoperative Period; D009215:Myometrium / Q000473:pathology*; D009361:Neoplasm Invasiveness; D015588:Observer Variation; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity