The Discrepancy between Preoperative Endometrial Pathology and Final Surgical Staging Endometrial Specimens in Endometrial Carcinoma Patients

Atthapon Jaishuen¹, Pisutt Srichaikul¹, Vuthinun Achariyapota, MD¹, Nida Jareemit, MD¹, Pattama Chaopotong, MD¹,
Khemanat Khemworapong, MD¹

Affiliation : ¹ Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Faculty of Medicine Siriraj Hospital, Bangkok, Thailand

Objective: 1) To establish the discrepancy between the histological results of preoperative endometrial pathology and the final surgical staging endometrial pathology for endometrial carcinoma. 2) To determine risk factors for upgrading histology after surgical staging.
Materials and Methods: The present study was a retrospective study that enrolled patients who were preoperatively diagnosed with endometrial carcinoma. Endometrial tissue was derived from various methods, such as endometrial aspiration, fractional curettage, and hysteroscopic resection. Thereafter, all patients underwent surgical staging at Siriraj Hospital, Thailand. Pathological reports and other informative data were collected and analyzed.
Results: Three hundred twenty patients were enrolled. There were 34.7% discrepancies between preoperative pathology and final pathology. Seventy-four patients (23.1%) had upgraded preoperative endometrial pathology compared with the final surgical staging endometrial pathology. The kappa correlation value between preoperative endometrial pathology and final surgical staging endometrial pathology was 0.62.
Conclusion: The correlation between preoperative and postoperative pathology was good. Preoperative endometrial pathology can predict the final surgical staging of endometrial pathology. However, surgeons must be aware of risk factors that influence the upgrading of grade1 or 2 endometrioid histology, such as myometrial invasion.

Keywords : Endometrial carcinoma; Upgrading; Preoperative pathology; Postoperative pathology

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