Endometrial cancer: accuracy of the finding of a well differentiated tumor at dilatation and curettage compared to the findings at subsequent hysterectomy.
The objective of this study was to examine the accuracy of the finding of a histologically well differentiated endometrial carcinoma at dilatation and curettage (D & C) prior to hysterectomy. A retrospective multicentric chart review of 137 endometrial cancer patients was conducted, including all patients in whom a well differentiated endometrial carcinoma had been diagnosed by D & C. Histopathologic grading as determined by D & C was compared with the grading established at the final histologic examination after hysterectomy. Seventy-eight percent of all cases in which a well differentiated tumor was diagnosed with D & C were confirmed as well differentiated endometrial carcinomas, whereas 20.4% had to be upgraded as moderately differentiated tumors after evaluation of the hysterectomy specimen. In one case in which a uterine adenocarcinoma was diagnosed by D & C, a well differentiated adenocarcinoma was found to be combined with a carcinosarcoma in the hysterectomy specimen. In order to avoid false findings of a well differentiated tumor, the histologic grade should be confirmed by intraoperative frozen section examination. This is especially important in cases in which surgical staging was not planned initially.
Department of Gynecology and Obstetrics, University Hospital of Vienna, Vienna;University Hospital of Graz, Graz;General Hospital of Wilhelminenspital, Vienna;General Hospital Salzburg, Salzburg;Hospital Barmherzige Schwestern, Linz;General Hospital Lainz, Vienna;General Hospital Sozialmedizinisches Zentrum Ost/Donauspital, Vienna;General Hospital Rudolftsiftung, Vienna;General Hospital Dornbirn, Dornbirn;Kaiser Franz Josef Hospital, Vienna, and Department of Clinical Pathology/Gynecopathology, University Hospital of Vienna, Vienna, Austria.
A.
A
Obermair
M.
M
Geramou
F.
F
Gücer
U.
U
Denison
A. H.
AH
Graf
E.
E
Kapshammer
M.
M
Medl
A.
A
Rosen
F.
F
Wierrani
W.
W
Neunteufel
I.
I
Frech
P.
P
Speiser
C.
C
Kainz
G.
G
Breitenecker