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- W1977996975 abstract "Surgical management of endometrial carcinoma includes a total hysterectomy, bilateral salpingo-oophorectomy and peritoneal washings with or without lymph node dissection. Our goal is to determine the clinical utility of transvaginal ultrasonography (TVUS) for predicting myometrial depth of invasion (DOI) and tumor size (TS) in low-grade endometrial adenocarcinoma to guide optimal surgical planning. 35 patients with low-grade endometrial adenocarcinoma seen between 10/2010 and 8/2014 received TVUS as part of surgical planning. 30 subjects underwent surgery; 5 chose fertility-sparing treatments and were thus excluded. DOI and TS as measured by TVUS was compared to final pathology measurements. Sensitivity, specificity, positive predictive value (PPV), negative predictive (NPV) and accuracy of TVUS for DOI and TS were obtained. Patients were primarily Hispanic (68%), with well- differentiated adenocarcinoma (70%). For DOI > 50% on TVUS, sensitivity was 50%, specificity was 92.3%, PPV was 50%, NPV was 92.3%, and accuracy was 86.6%. For TS > or = 2cm on TVUS, sensitivity was 87.5%, specificity was 33.3%, PPV was 84%, NPV was 40% and accuracy was 76.6%. In 2 of 4 patients where TVUS DOI was incorrect, the evaluation was noted to be suboptimal. Given risks associated with lymphadenectomy, predictive models to determine clinical necessity of this procedure are imperative. The Mariani model suggests low risk of nodal spread with low-grade histology, myometrial DOI < 50%, and TS < 2cm. However, these criteria are based on frozen section, which leads to longer operative times, higher costs and increased morbidity for patients. Overall, our findings are consistent with previously published studies; however, sensitivity may be lower due to a small sample size. Given its diagnostic accuracy, TVUS is a cost-effective, non-invasive adjunct in surgical planning for early stage, low-grade endometrial cancers. Prospective studies are needed to compare the accuracy of preoperative TVUS to postoperative and frozen section pathology. A cost analysis of both preoperative TVUS and intraoperative frozen section may be beneficial." @default.
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- W1977996975 date "2015-04-01" @default.
- W1977996975 modified "2023-10-18" @default.
- W1977996975 title "2037017 Preoperative Transvaginal Ultrasound is an Effective Tool For Assessing Depth of Myometrial Invasion and Tumor Size in Low Grade Endometrial Cancer" @default.
- W1977996975 doi "https://doi.org/10.1016/j.ultrasmedbio.2014.12.430" @default.
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