[Preoperative endovaginal ultrasound in the assessment of myometrial invasion of endometrial adenocarcinoma].
OBJECTIVE
To determine, according to histological tumor grade, the reliability of preoperative endovaginal ultrasound in the detection of myometrial invasion in patients with stage I endometrial cancer.


METHODS
Sixty-one patients with stage I endometrial carcinoma were evaluated with preoperative endovaginal ultrasound compared to postoperative results of pathologic examination, in a six-year retrospective study.


RESULTS
Twenty-nine patients had a deep myometrial invasion (stage IC). The mean endometrial thickness was 9.5 mm in stage IA, 17.0 mm in stage IB and 20.0 mm in stage IC disease (P = 0.01). The sensitivity and the specificity of the ultrasound in the assessment of myometrial invasion in grade 1 tumors were 100% and 93.7%, respectively. They fell to 69.2% and 88.9% for high-grade tumors. The global accuracy of ultrasound was 82%.


CONCLUSIONS
The performance of preoperative ultrasound varies according to the literature. The association of morphological and morphometric criteria enables an increase in the sensitivity of the exam. In grade 1 tumors, the preoperative endovaginal ultrasound could help in identifying a group of patients at low risk of lymph node metastasis for which a pelvic lymphadenectomy would be avoidable.
Yazbeck
C
C
Service de gynécologie-obstétrique, hôpital Bichat-Claude-Bernard, 46, rue Henri-Huchard, 75018, Paris, France. chayaz@cyberia.net.lb
Poncelet
C
C
Créquat
J
J
Madelenat
P
P
D000230:Adenocarcinoma / Q000000981:diagnostic imaging* / Q000473:pathology*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016889:Endometrial Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology*; D005260:Female; D006801:Humans; D008875:Middle Aged; D009215:Myometrium / Q000000981:diagnostic imaging* / Q000473:pathology; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D011300:Preoperative Care; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D014463:Ultrasonography