Pilot study prospectively evaluating the use of the measurement of preoperative sonographic endometrial thickness in postmenopausal patients with endometrial cancer.
OBJECTIVE
The value of sonographic evaluation of the endometrial thickness as a screening or a prognostic tool for endometrial cancer remains controversial. The objective of this study was to prospectively evaluate the endometrial thickness in women with known endometrial cancer to assess the predictive value of this modality and its preoperative use in this disease.


METHODS
In a prospective, nonrandomized trial, 29 patients with pathologically confirmed endometrial cancer had preoperative transvaginal ultrasound and endometrial thickness evaluated. Body mass index (BMI) and endometrial thickness were recorded and correlated with surgical and pathologic information.


RESULTS
The median age at diagnosis of endometrial cancer was 61.6 years (range, 48-87 years). Tumor grade was as follows: grade 1, 23; grade 2, 3; and grade 3, 3. All patients had an endometrial stripe of 5.0 mm or more. The median preoperative sonographic endometrial stripe was 12.0 mm (range, 5.0-32.0 mm). After surgery, 25 patients (86%) were diagnosed with International Federation of Gynecology and Obstetrics (FIGO) stage I disease (IA, 8; IB, 14; IC, 3), 2 (7%) with stage II disease, and 2 (7%) with stage III disease. Median BMI was 33 (range, 20-56). The patients' BMIs were found to be directly associated with endometrial thickness (rank correlation = 0.39; P = 0.03). Stage was only marginally associated with endometrial thickness (correlation 0.23; P = 0.07). Sonographic endometrial thickness was not associated with depth of myometrial invasion. No correlation was found between endometrial thickness and patient age or tumor grade.


CONCLUSIONS
Although patients with endometrial cancer and a high BMI are likely to have a thickened endometrial stripe, endometrial thickness does not correlate with tumor grade or stage. The use of preoperative transvaginal ultrasound in diagnosed endometrial cancer appears limited.
Eitan
Ram
R
Gynecology Service, Department of Surgery, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, NY 10021, USA.
Saenz
Cheryl C
CC
Venkatraman
Ennapadam S
ES
Hann
Lucy
L
Bach
Ariadne
A
Gretz
Elissa
E
Barakat
Richard R
RR
Chi
Dennis S
DS
D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D016889:Endometrial Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology* / Q000601:surgery; D004717:Endometrium / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D008875:Middle Aged; D009367:Neoplasm Staging; D017063:Outcome Assessment, Health Care; D010865:Pilot Projects; D017698:Postmenopause; D011300:Preoperative Care; D011446:Prospective Studies; D014463:Ultrasonography