title: Accuracy of preoperative curettage in determining tumor type and grade in endometrial cancer.
abstract: OBJECTIVE
  To compare the accuracy of tumor grade and type in endometrial cancer between samples from preoperative curettage and postoperative hysterectomy specimens.
  
  
  METHODS
  From January 2002 to June 2006, 98 women diagnosed with endometrial cancer and treated in the Department of Obstetrics and Gynecology, Siriraj Hospital were included The comparisons of tumor types and grades were performed on both preoperative endometrial curettage and hysterectomy specimens; the relationships between the concordance rate and accuracy of types and grades were analyzed.
  
  
  RESULTS
  Endometrial samples and the subsequent hysterectomy specimens from 98 patients were studied After exclusion of benign endometrial tissue sampling and no residual tumor in hysterectomy specimen and preoperative diagnosis from endometrial biopsy, 86 patients were analyzed The overall tumor type accuracy was 93.0% for endometrioid type. The comparative FIGO grades were analyzed between preoperative endometrial samplings and hysterectomy specimens. Accuracy was 74.0% for grade 1, 75.3% for grade 2 and 90.4% for grade 3. The accuracy for grade 3 tumors was significantly higher than for grade 1.
  
  
  CONCLUSIONS
  The authors should be careful in planning patient management based on the initial histological findings. It is important for clinicians to be aware that endometrial adenocarcinoma may show focal variation in tumor grade and to be aware of the limitation of examination of small tissue samples.
authors.affiliation: Gynecologic Oncology Unit, Department ofObstetrics and Gynecology, Faculty ofMedicine Siriraj Hospital, Mahidol University Bangkok, Thailand. drwansian@yahoo.com
authors.forename: Amornrat
authors.initials: A
authors.lastname: Thanachaiviwat
authors.forename: Chaiyod
authors.initials: C
authors.lastname: Thirapakawong
authors.forename: Chairat
authors.initials: C
authors.lastname: Leelaphatanadit
authors.forename: Tuenjai
authors.initials: T
authors.lastname: Chuangsuwanich
mesh_terms: D000328:Adult; D000368:Aged; D001706:Biopsy; D018269:Carcinoma, Endometrioid / Q000145:classification / Q000473:pathology*; D004107:Dilatation and Curettage / Q000379:methods*; D016889:Endometrial Neoplasms / Q000145:classification / Q000473:pathology*; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000379:methods*; D008875:Middle Aged; D009367:Neoplasm Staging; D011184:Postoperative Period; D011300:Preoperative Care; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012680:Sensitivity and Specificity