Biomedical Cancer Research Unit, Instituto Nacional de Cancerología, Mexico City, Mexico.
Biomedical Investigations Institute, Universidad Nacional Autonóma de México, Mexico City, Mexico.
World J Surg Oncol. 2020 Oct 30;18(1):284. doi: 10.1186/s12957-020-02056-7.
Endometrial carcinoma is the most common gynecologic malignancy in developed countries. Grade 2 carcinoma is associated with pelvic lymph-node metastasis, depending on selected risk factors. Intraoperative assessment (IOA) can identify patients at risk for lymph node metastasis who should undergo staging surgery. Our objective was to establish the diagnostic precision of IOA in determining the need for surgical staging in grade 2 endometrioid endometrial carcinoma.
Two hundred twenty-two patients underwent IOA. Results were compared to the final pathology report. The accuracy of the IOA parameters was calculated. Variables were evaluated in patients with positive versus negative IOA. Overall and disease-free survivals were calculated according to IOA, lymphadenectomy, and nodal metastasis.
IOA was positive in 80 patients. It showed an accuracy of 76.13% when compared with the postoperative assessment. The best individual parameter was myometrial invasion. Nodal metastasis was observed in 16 patients in the positive IOA group and 7 patients in the negative group. Patients with lymph node metastasis had a 5-year overall survival rate of 80.9%, whereas patients without metastasis had a 5-year overall survival rate of 97.9%.
IOA is an adequate tool to identify high-risk patients in grade 2 endometrial carcinoma. Myometrial invasion is the individual parameter that yields the highest diagnostic precision.
子宫内膜癌是发达国家最常见的妇科恶性肿瘤。2 级癌与盆腔淋巴结转移相关，取决于选定的危险因素。术中评估（IOA）可以识别有淋巴结转移风险的患者，这些患者应接受分期手术。我们的目的是确定 IOA 在确定 2 级子宫内膜样子宫内膜癌手术分期需求方面的诊断精度。
222 例患者接受 IOA。结果与最终病理报告进行比较。计算 IOA 参数的准确性。评估 IOA 阳性与阴性患者的变量。根据 IOA、淋巴结切除术和淋巴结转移计算总生存率和无病生存率。
80 例患者 IOA 阳性。与术后评估相比，其准确率为 76.13%。最佳的个体参数是肌层浸润。在 IOA 阳性组中观察到 16 例淋巴结转移，在 IOA 阴性组中观察到 7 例淋巴结转移。有淋巴结转移的患者 5 年总生存率为 80.9%，而无转移的患者 5 年总生存率为 97.9%。
IOA 是识别 2 级子宫内膜癌高危患者的有效工具。肌层浸润是诊断精度最高的个体参数。
