title: Preoperative diagnosis of tumor grade and type in endometrial cancer by pipelle sampling and hysteroscopy: Results of a French study.
abstract: BACKGROUND
  No data are available to establish whether operative hysteroscopy is superior to standard pipelle sampling to determine histological and grade status in endometrial cancer (EC). The aim of this study was to evaluate whether pipelle device sampling or operative hysteroscopy had an impact on preoperative determination of histological and grade status in EC and consequently on surgical management.
  
  
  METHODS
  Data of 224 women with EC receiving primary surgical treatment between 2002 and 2014 were abstracted from a single institution with maintained database. Women were staged on the basis of preoperative and final pathological findings according to the 2009 International FIGO classification. Discrepancies in pathological analysis were assessed between pipelle sampling or operative hysteroscopy and final histology. Values of p < 0.05 were considered to denote significant differences.
  
  
  RESULTS
  149 women underwent preoperative pipelle sampling and 75 operative hysteroscopy. Global discrepancies between pre-operative and post-operative analysis was 20.8% versus 20.0% in the pipelle device and operative hysteroscopy group, respectively, with no significant difference considering type 1 grade 1 or 2 versus type 1 grade 3 versus type 2 EC. Discrepancies in histological type between preoperative and final histology were found in 25 (16.8%) and 11 (14.7%) women in the pipelle device and operative hysteroscopy groups, respectively (p = 0.85). Discrepancies in histological grade between preoperative and final histology were found in 6 (5.8%) vs. 4 (7.0%) of the women in the pipelle device and operative hysteroscopy groups, respectively (p = 1).
  
  
  CONCLUSIONS
  This study suggests that both pipelle sampling and operative hysteroscopy are of limited value in determining definitive histological type and grade. Additional investigations should be evaluated to better characterize the risk groups.
authors.affiliation: Department of Obstetrics and Gynaecology, Tenon University Hospital, Assistance Publique des Hôpitaux de Paris (AP-HP), University Pierre and Marie Curie, Institut Universitaire de Cancérologie (IUC), Paris 6, Paris, France.
authors.forename: Juliette
authors.initials: J
authors.lastname: Phelippeau
authors.affiliation: Department of Obstetrics and Gynaecology, Tenon University Hospital, Assistance Publique des Hôpitaux de Paris (AP-HP), University Pierre and Marie Curie, Institut Universitaire de Cancérologie (IUC), Paris 6, Paris, France; INSERM UMR S 938, University Pierre et Marie Curie, Paris, France. Electronic address: geoffroy.canlorbe@tnn.aphp.fr.
authors.forename: Geoffroy
authors.initials: G
authors.lastname: Canlorbe
authors.affiliation: Department of Obstetrics and Gynaecology, Tenon University Hospital, Assistance Publique des Hôpitaux de Paris (AP-HP), University Pierre and Marie Curie, Institut Universitaire de Cancérologie (IUC), Paris 6, Paris, France; INSERM UMR S 707, Epidemiology, Information Systems, Modeling, University Pierre and Marie Curie, Paris, France.
authors.forename: Sofiane
authors.initials: S
authors.lastname: Bendifallah
authors.affiliation: Department of Obstetrics and Gynaecology, Tenon University Hospital, Assistance Publique des Hôpitaux de Paris (AP-HP), University Pierre and Marie Curie, Institut Universitaire de Cancérologie (IUC), Paris 6, Paris, France.
authors.forename: Iptissem
authors.initials: I
authors.lastname: Naoura
authors.affiliation: Department of Pathology, Tenon University Hospital, University Pierre and Marie Curie, Paris, France.
authors.forename: Marine
authors.initials: M
authors.lastname: Lefevre
authors.affiliation: Department of Obstetrics and Gynaecology, Tenon University Hospital, Assistance Publique des Hôpitaux de Paris (AP-HP), University Pierre and Marie Curie, Institut Universitaire de Cancérologie (IUC), Paris 6, Paris, France; INSERM UMR S 938, University Pierre et Marie Curie, Paris, France.
authors.forename: Marcos
authors.initials: M
authors.lastname: Ballester
authors.affiliation: Department of Obstetrics and Gynaecology, Tenon University Hospital, Assistance Publique des Hôpitaux de Paris (AP-HP), University Pierre and Marie Curie, Institut Universitaire de Cancérologie (IUC), Paris 6, Paris, France; INSERM UMR S 938, University Pierre et Marie Curie, Paris, France.
authors.forename: Emile
authors.initials: E
authors.lastname: Daraï
mesh_terms: D000368:Aged; D001706:Biopsy / Q000295:instrumentation*; D016889:Endometrial Neoplasms / Q000175:diagnosis* / Q000601:surgery; D005260:Female; D005602:France; D006801:Humans; D015907:Hysteroscopy / Q000379:methods*; D008875:Middle Aged; D060787:Neoplasm Grading; D009367:Neoplasm Staging; D011300:Preoperative Care; D011379:Prognosis; D012494:Sampling Studies
keywords: Endometrial cancer; Histological discrepancy; Operative hysteroscopy; Pipelle device