Diagnostic Methods for Endometrial Lesions and Pre-operative Imaging Study for Endometrial Cancer: Survey of Practice among Thai Gynecologic Oncologists
Chanpanitkitchot S, MD1, Suwannarurk K, MD2, Hamontri S, MD3, Manusirivithaya S, MD4, Tangjitgamol S, MD4, Thai Gynecologic Cancer Society (TGCS)5
Affiliation : 1 Department of Obstetrics and Gynecology, Rajavithi Hospital, College of Medicine, Rangsit University, Bangkok, Thailand 2 Gynecologic Oncology Unit, Department of Obstetrics & Gynecology, Faculty of Medicine, Thammasat University, Pathumthani, Thailand 3 Department of Obstetrics and Gynecology, HRH Princess Maha Chakri Sirindhorn Medical Center, Faculty of Medicine, Srinakharinwirot University, Nakhon Nayok, Thailand 4 Gynecologic Oncology Unit, Department of Obstetrics and Gynecology, Faculty of Medicine Vajira Hospital, Navamindradhiraj University, Bangkok, Thailand 5 Thai Gynecologic Cancer Society (TGCS), Bangkok, Thailand
Objective : To study the practice of Thai gynecologic oncologists regarding methods for diagnosis of endometrial lesions and
preoperative investigation of endometrial cancer.
Materials and Methods : The present study was a part of the national practice survey of the Thai Gynecologic Cancer Society (TGCS)
on the management of gynecologic cancer in Thailand. Thai gynecologic oncologists who had worked for more than 1 year were
invited to respond to web-based questionnaires which were opened from August to October, 2019. The present study reviewed
data of operative means to obtain endometrial tissue for diagnosis and preoperative investigations of EMC patients.
Results : Of 170 respondents, the mean age was 41.1+8.25 years old. Endometrial biopsy (70%) was more common than uterine
curettage (30%). The biopsy was performed more frequently among the respondents working in government, tertiary, training
hospitals and with less than 5 years duration of practice. The differences were significant between the respondents working in the
tertiary or training hospitals than their comparative groups. Over 90% of the respondents also obtained endocervical tissue for
histopathologic examination, however, at different frequencies. Only the respondents who worked in private hospitals ‘always’
performed endocervical curettage more frequently than those in government hospitals. Only 23.5% routinely requested imaging
study; this was found especially among the respondents working in secondary hospitals. The other 1.8% never requested any
imaging study at all whereas 74.7% selectively had imaging study; the most common indications were advanced disease or incomplete
surgical staging.
Conclusion : There were variations of diagnostic methods to evaluate the endometrial lesion and the use of pre-operative imaging
for EMC patients among Thai gynecologic oncologists. The differences resided in the work setting and experience of the respondents.
Keywords : Survey, Practice, Gynecologic Cancer, Endometrial Cancer, Diagnosis, Imaging
