title: [Pertinence of the preoperative exploration in the evaluation of the risk of lymph node metastasis in endometrial cancer].
abstract: OBJECTIVE
  To assess the relevance of MRI, endometrial biopsy and curettage in the diagnosis of endometrial cancer at high risk of lymph node metastasis.
  
  
  METHODS
  A retrospective study on continuous series of patients treated for endometrial cancer limited to the uterus between 2004 and 2008, results of preoperative evaluation of tumor stage using MRI, histological type and grade by endometrial curettage and biopsies were compared to final histological examination.
  
  
  RESULTS
  One hundred and sixty-nine patients were included in the study. Ninety (53.3%) had MRI, 112 (66.2%) curettage and 61 (36.6%) endometrial biopsy using Pipelle de Cornier. Sensibility (SN), specificity (SP), positive (PPV) and negative predictive values (NPV) of MRI, in the diagnosis of endometrial cancer at high risk of lymph nodes metastases were of 65.6%, 87.2%, 77.7%, 79.2%. For EB and curettage SN, SP, PPV and NPV were of 42.9%, 96.9%, 85%, 79.5%; 80.6%, 98.3%, 96.2% and 90.6% respectively. 37.8% of cancers diagnosed to be at low risk of lymph node metastasis were at high risk in definitive histologic examination.
  
  
  CONCLUSIONS
  Preoperative evaluation by MRI, endometrial curettage and biopsy has good diagnostic value in the identification of endometrial cancer susceptible to benefit from lymphadenectomy. Underestimation, however, is encountered in approximately one third of cases.
authors.affiliation: Service de chirurgie gynécologique et oncologique, CHU de Strasbourg, 1, avenue Molière, 67098 Strasbourg cedex, France.
authors.forename: B
authors.initials: B
authors.lastname: Groff
authors.affiliation: Service gynécologique-obstétrique, CHU de Nîmes, place du professeur R.-Debré, 30029 Nîmes cedex 9, France.
authors.forename: O
authors.initials: O
authors.lastname: Pouget
authors.affiliation: Service de chirurgie gynécologique et oncologique, CHU de Strasbourg, 1, avenue Molière, 67098 Strasbourg cedex, France.
authors.forename: F
authors.initials: F
authors.lastname: Stoll
authors.affiliation: Service de sénologie et de pathologie mammaire, CHU de Strasbourg, 1, avenue Molière, 67098 Strasbourg cedex, France.
authors.forename: C
authors.initials: C
authors.lastname: Mathelin
authors.affiliation: Service de chirurgie gynécologique et oncologique, CHU de Strasbourg, 1, avenue Molière, 67098 Strasbourg cedex, France. Electronic address: baldauf.jean-jaques@chru-strasbourg.fr.
authors.forename: J J
authors.initials: JJ
authors.lastname: Baldauf
authors.affiliation: Service de chirurgie gynécologique et oncologique, CHU de Strasbourg, 1, avenue Molière, 67098 Strasbourg cedex, France. Electronic address: cherif.youssef2@wanadoo.fr.
authors.forename: C Y
authors.initials: CY
authors.lastname: Akladios
mesh_terms: D000368:Aged; D001706:Biopsy; D003475:Curettage; D016889:Endometrial Neoplasms / Q000473:pathology*; D004717:Endometrium / Q000473:pathology; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis / Q000473:pathology*; D008279:Magnetic Resonance Imaging; D009367:Neoplasm Staging / Q000379:methods; D011300:Preoperative Care; D012189:Retrospective Studies; D012306:Risk; D012680:Sensitivity and Specificity
keywords: Cancer de l’endomètre; Curetage endométrial; Endometrial biopsy; Endometrial cancer; Endometrial curettage; FIGO staging; Grade histologique; Histological type; IRM; MRI; Pipelle de Cornier(®); Stade FIGO; Tumor grade; Type histologique