title: How to improve the preoperative staging of presumed early-stage endometrioid endometrial cancer?
abstract: OBJECTIVE
  Accurate preoperative staging of early-stage endometrioid endometrial cancer (EEC) is necessary to avoid under or over surgical treatment. The objective is to determine the rate of understaging and to evaluate the accuracy of different methods: hysteroscopy-curettage versus endometrial biopsy in predicting the final stage.
  
  
  METHODS
  This retrospective single-centre study led from 2000 to 2010, included women with EEC preoperatively assessed at low- or intermediate-risk. Understaging was defined as a postoperative FIGO Stage > 1 or a determination of high risk after the final histopathologic diagnosis.
  
  
  RESULTS
  The study included 101 women (75 low-risk and 26 intermediate-risk). Final diagnosis was upstaged for 26 of them, more frequently in the presumed intermediate-risk group (57.7% vs 14.7%, p < 0.001). The rate of preoperative understaging was higher in the women with endometrial biopsies than those with curettage (34.5% vs 15.2%, p = 0.04).
  
  
  CONCLUSIONS
  Hysteroscopy-curettage combined with magnetic resonance imaging (MRI) may improve preoperative staging of early-stage EEC, especially for presumed intermediate-risk disease.
authors.forename: G
authors.initials: G
authors.lastname: Bleu
authors.forename: E
authors.initials: E
authors.lastname: Arsène
authors.forename: B
authors.initials: B
authors.lastname: Merlot
authors.forename: O
authors.initials: O
authors.lastname: Kerdraon
authors.forename: J
authors.initials: J
authors.lastname: Bigot
authors.forename: L
authors.initials: L
authors.lastname: Boulanger
authors.forename: B
authors.initials: B
authors.lastname: Dedet
authors.forename: D
authors.initials: D
authors.lastname: Vinatier
authors.forename: P
authors.initials: P
authors.lastname: Collinet
mesh_terms: D000368:Aged; D018269:Carcinoma, Endometrioid / Q000473:pathology* / Q000601:surgery; D003475:Curettage; D016889:Endometrial Neoplasms / Q000473:pathology* / Q000601:surgery; D005260:Female; D006801:Humans; D015907:Hysteroscopy; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D009367:Neoplasm Staging; D012189:Retrospective Studies