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 ORIGINAL ARTICLE
Year : 2015  |  Volume : 52  |  Issue : 4  |  Page : 677-680

Discrepancy between clinicoradiological and surgicopathological staging in stage 1 carcinoma endometrium: Identification of risk factors


Department of Surgical and Gynaecological Oncology, Lakeshore Hospital, Cochin, Kerala, India

Correspondence Address:
S Neetha
Department of Surgical and Gynaecological Oncology, Lakeshore Hospital, Cochin, Kerala
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0019-509X.178440

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INTRODUCTION: Carcinoma endometrium carries an excellent prognosis when diagnosed early. But controversies exist in the management of Ca endometrium confined to the uterus as to whether a complete surgical staging including lymph node dissection is needed always. This may increase unnecessary surgical morbidity for some. On the other hand, if not done it fails to recognize a subset of patients who require adjuvant treatment, thus affecting the outcome. Hence it is very important to categorize the patients to assess the need of complete surgical staging. AIM: The aim of the following study is to identify the risk factors influencing the upstaging of disease in clinicoradiologically stage 1 carcinoma endometrium. MATERIALS AND METHODS: A retrospective database evaluation of all cases of clinicoradiologically stage 1 carcinoma endometrium from January 2009 to September 2012. STATISTICAL ANALYSIS: Done using the statistical software SPSS − version 16 for windows (SPSS Inc. 233 South Wacker Drive, 11th Floor Chicago, IL 60606-6412) Independent samples test (t-test for equality of means) were done and (two-tailed) P < 0.05 − were significant. RESULTS: Carcinoma endometrium patients with grade 1, no or < 50% myometrial involvement, <2 cm size and no isthmus involvement had low risk of upstaging. CONCLUSION: Significant upstaging is seen in the present study with per-operative staging procedures. Until the standardization of magnetic resonance imaging (MRI) techniques and reporting, or until a more sensitive non-invasive technique is devised, staging lymphadenectomy appears to be invaluable in risk assessment and prognosis.






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