Intratumoral blood flow analysis in endometrial carcinoma: correlation with tumor characteristics and risk for recurrence.
OBJECTIVE
The aim of this study was to correlate intratumoral blood flow as assessed by transvaginal color Doppler ultrasound with tumor histopathologic characteristics, tumoral stage, and risk for recurrence in endometrial carcinoma.


METHODS
Forty-five patients (mean age: 58.2 years, range: 30 to 83 years) with surgically treated endometrial carcinoma preoperatively evaluated with transvaginal color Doppler ultrasound were included in this retrospective study. The lowest arterial resistance index (RI) and highest peak systolic velocity (PSV) were used for intratumoral blood flow analysis. Individual tumor characteristics evaluated were tumor growth pattern, tumor size, histologic type, tumor grade, myometrial infiltration depth, cervical involvement, lymph node metastasis, and lymph-vascular space invasion (LVSI). Tumoral stage and risk for recurrence were also evaluated.


RESULTS
Significantly lower RI was found in tumors with the following characteristics: infiltrative growth pattern (P = 0,013), grade 3 (P = 0.001), infiltrating >or=50% of the myometrium (P = 0.006), cervical involvement (P = 0.009), LVSI (P = 0.008), lymph-node metastasis (P = 0.049), stage >or=Ic (P = 0.004), and high risk for recurrence (P = 0.001). Significantly higher PSV was found in tumors that were grade 3 (P = 0.034), infiltrating >or=50% of the myometrium (P = 0.029), stage >or=Ic (P = 0.015), and with a high risk for recurrence (P = 0.002).


CONCLUSIONS
Our data indicate that a correlation between intratumoral blood flow features and histopathological characteristics, tumor stage, and risk for recurrence exists in endometrial cancer. Further prospective studies are needed to determine the clinical usefulness of preoperative assessment of tumor vascularization in these carcinomas.
Alcázar
Juan Luis
JL
Department of Obstetrics and Gynecology, University of Navarra, Pamplona, Spain. jlalcazar@unav.es
Galán
María José
MJ
Jurado
Matías
M
López-García
Guillermo
G
D000230:Adenocarcinoma / Q000098:blood supply* / Q000000981:diagnostic imaging / Q000473:pathology; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016889:Endometrial Neoplasms / Q000098:blood supply* / Q000000981:diagnostic imaging / Q000473:pathology; D005260:Female; D006801:Humans; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000098:blood supply* / Q000000981:diagnostic imaging / Q000473:pathology; D009367:Neoplasm Staging; D009389:Neovascularization, Pathologic / Q000000981:diagnostic imaging*; D012307:Risk Factors; D018615:Ultrasonography, Doppler, Color