title: Effects of Endometrial Ablation on Treatment Planning in Women With Endometrial Cancer.
abstract: To evaluate effects of endometrial ablation on the staging and treatment planning of postablation endometrial cancer. After authorization from the institutional review board, we performed a retrospective chart review of patients with a history of endometrial ablation and a subsequent diagnosis of endometrial cancer from July 2006 to December 2013. The information obtained included patient's age at time of cancer diagnosis, pre-ablation endometrial biopsy histology, dilation and curettage histology at time of ablation, endometrial biopsy-to-ablation interval, ablation-to-hysterectomy interval, final pathologic diagnosis, Fédération Internationale de Gynécologie et d'Obstétrique (FIGO) staging, and treatment recommendations for adjuvant therapy. The histopathology was examined by a gynecologic pathologist. The National Comprehensive Cancer Network guidelines were applied to determine need for adjuvant therapy. Six of 490 (1.2%) patients with endometrial cancer were identified to have an antecedent ablation. Mean patient age was 48.2 years (range: 40-53). The time interval from office pre-ablation endometrial sampling to ablation ranged from 1 to 17 months. Four patients (67%) had an undetected endometrial cancer at the time of ablation, despite having benign pre-ablation histology. Following surgical staging, 4 patients (67%) had no evidence of residual carcinoma, and 2 (33%) had evidence of endometrial adenocarcinoma grades 1 to 2. There was no evidence of myometrial invasion in all cases, and a FIGO stage of IA was assigned. No adjuvant therapies were indicated. There have been no documented cancer recurrences, with a follow-up range from 16 to 52 months (average 30.2). Endometrial ablation artifact does not appear to hinder evaluation and treatment planning in the presence of endometrial cancer.
authors.affiliation: Department of Obstetrics and Gynecology, St Francis Hospital and Medical Center, Hartford, Connecticut.
authors.forename: Erica
authors.initials: E
authors.lastname: Argall
authors.affiliation: Department of Pathology, St Francis Hospital and Medical Center, Hartford, Connecticut.
authors.forename: Anna
authors.initials: A
authors.lastname: Jovanovic
authors.affiliation: Department of Obstetrics and Gynecology, St Francis Hospital and Medical Center, Hartford, Connecticut. Electronic address: RFiguero@stfranciscare.org.
authors.forename: Reinaldo
authors.initials: R
authors.lastname: Figueroa
authors.affiliation: Department of Obstetrics and Gynecology, St Francis Hospital and Medical Center, Hartford, Connecticut.
authors.forename: Allan
authors.initials: A
authors.lastname: Mayer
authors.affiliation: Department of Obstetrics and Gynecology, St Francis Hospital and Medical Center, Hartford, Connecticut.
authors.forename: Beth
authors.initials: B
authors.lastname: Nelson
authors.affiliation: Department of Obstetrics and Gynecology, St Francis Hospital and Medical Center, Hartford, Connecticut.
authors.forename: Phillip
authors.initials: P
authors.lastname: Roland
mesh_terms: D000328:Adult; D003131:Combined Modality Therapy; D055356:Endometrial Ablation Techniques; D016889:Endometrial Neoplasms / Q000473:pathology / Q000601:surgery*; D004717:Endometrium / Q000473:pathology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007044:Hysterectomy; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000517:prevention & control / Q000601:surgery*; D012189:Retrospective Studies
keywords: Endometrial ablation; Endometrial cancer; Endometrial histology; Pre-ablation endometrial biopsy