Article (Scientific journals)
Concordance between preoperative ESMO-ESGO-ESTRO risk classification and final histology in early-stage endometrial cancer.
Daix, Manon; Angeles, Martina Aida; Migliorelli, Federico et al.
2021In Journal of Gynecologic Oncology, 32 (4), p. 48
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Keywords :
Biopsy; Cancer Staging; Endometrial Cancer; Magnetic Resonance Imaging; Risk Assessment; Sentinel Lymph Node; Female; Humans; Lymph Node Excision; Medical Oncology; Neoplasm Staging; Retrospective Studies; Sentinel Lymph Node Biopsy; Endometrial Neoplasms/diagnostic imaging; Endometrial Neoplasms/pathology; Endometrial Neoplasms/surgery; Endometrial Neoplasms; Oncology; Obstetrics and Gynecology; General Medicine
Abstract :
[en] [en] OBJECTIVE: To evaluate the concordance between preoperative European Society for Medical Oncology (ESMO)-European Society of Gynaecological Oncology (ESGO)-European SocieTy for Radiotherapy and Oncology (ESTRO) risk classification in early-stage endometrial cancer (EC) assessed by biopsy and magnetic resonance imaging (MRI) with this classification based on histology of surgical specimen. METHODS: This bicentric retrospective study included women diagnosed with early-stage EC (≤stage II) who had a complete preoperative assessment and underwent a surgical management from January 2011 to December 2018. Patients were preoperatively classified into 3 degrees of risk of lymph node (LN) involvement based on biopsy and MRI. Based on final histological report, patients were re-classified using the preoperative classification. Concordance between the preoperative assessment and definitive histology was calculated with weighted Cohen's kappa coefficient. RESULTS: A total of 333 women were included and kappa coefficient of preoperative risk classification was 0.49. The risk was underestimated and overestimated in 37% and 10% of cases, respectively. Twenty-nine percent of patients had an incomplete LN staging according to the degree of risk of re-classification. The observed discordance in the risk classification was attributed to MRI in 75% of cases, to biopsy in 18% and in 7% to both (p<0.001). Kappa coefficient for concordance was 0.25 for MRI and 0.73 for biopsy. CONCLUSION: Concordance between preoperative ESMO-ESGO-ESTRO risk classification and final histology is weak. Given that the risk was underestimated in the majority of patients wrongly classified, sentinel LN procedure instead of no LN dissection could be an option offered to preoperative low-risk patients to decrease the indication of second surgery for re-staging and/or to avoid toxicity of adjuvant radiotherapy.
Disciplines :
Oncology
Author, co-author :
Daix, Manon  ;  Université de Liège - ULiège > Département des sciences cliniques > Anesthésie et réanimation ; Department of Surgical Oncology, Institut Universitaire du Cancer de Toulouse - Institut Claudius Regaud, Oncopole, Toulouse, France ; Department of Gynecology, Centre Hospitalier Chrétien - Mont Légia, Liège, Belgium. manondaix89@gmail.com
Angeles, Martina Aida ;  Department of Surgical Oncology, Institut Universitaire du Cancer de Toulouse - Institut Claudius Regaud, Oncopole, Toulouse, France
Migliorelli, Federico ;  Department of Gynecology, Centre Hospitalier Intercommunal des Vallées de l'Ariège, Saint Jean de Verges, France
Kakkos, Athanasios  ;  Centre Hospitalier Universitaire de Liège - CHU > > Service de gynécologie-obstétrique
Martinez Gomez, Carlos ;  Department of Surgical Oncology, Institut Universitaire du Cancer de Toulouse - Institut Claudius Regaud, Oncopole, Toulouse, France ; Inserm CRCT, Toulouse, France
Delbecque, Katty  ;  Centre Hospitalier Universitaire de Liège - CHU > > Service d'anatomie et cytologie pathologiques
Mery, Eliane ;  Department of Pathology, Institut Universitaire du Cancer de Toulouse - Institut Claudius Regaud, Oncopole, Toulouse, France
Tock, Stéphanie ;  Department of Gynecology, Centre Hospitalier Chrétien - Mont Légia, Liège, Belgium
Gabiache, Erwan ;  Department of Medical Imaging, Institut Universitaire du Cancer de Toulouse - Institut Claudius Regaud, Oncopole, Toulouse, France
De Cuypere, Marjolein  ;  Université de Liège - ULiège > Département des sciences cliniques
Goffin, Frédéric  ;  Centre Hospitalier Universitaire de Liège - CHU > > Service de gynécologie-obstétrique (CHR)
Martinez, Alejandra ;  Department of Surgical Oncology, Institut Universitaire du Cancer de Toulouse - Institut Claudius Regaud, Oncopole, Toulouse, France ; Inserm CRCT, Toulouse, France
Ferron, Gwénaël ;  Department of Surgical Oncology, Institut Universitaire du Cancer de Toulouse - Institut Claudius Regaud, Oncopole, Toulouse, France ; Inserm CRCT, Toulouse, France
Kridelka, Frédéric  ;  Centre Hospitalier Universitaire de Liège - CHU > > Service de gynécologie-obstétrique
More authors (4 more) Less
Language :
English
Title :
Concordance between preoperative ESMO-ESGO-ESTRO risk classification and final histology in early-stage endometrial cancer.
Publication date :
July 2021
Journal title :
Journal of Gynecologic Oncology
ISSN :
2005-0380
eISSN :
2005-0399
Publisher :
Korean Society of Gynecologic Oncology and Colposcopy, Korea south
Volume :
32
Issue :
4
Pages :
e48
Peer reviewed :
Peer Reviewed verified by ORBi
Funders :
La Caixa Foundation [ES]
Funding text :
Martina Aida Angeles acknowledges the grant support from “la Caixa” Foundation, Barcelona (Spain), ID 100010434. The fellowship code is LCF/BQ/EU18/11650038.
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