scholarly journals Comparison of MRI findings with actual HPE findings in case of carcinoma endometrium

2016 ◽  
Author(s):  
Shaveta Gupta
Keyword(s):  
Endometrial Cancer ◽  
Lymph Node ◽  
Myometrial Invasion ◽  
Lymph Node Involvement ◽  
Common Finding ◽  
Mri Findings ◽  
Pelvic Mri ◽  
Histopathological Findings ◽  
Node Involvement ◽  
Cervical Involvement

Objectives: The objectives of this study is to investigate the correlation of magnetic resonance imaging (MRI) in predicting the depth of myometrial invasion, cervical involvement and lymph node involvement and actual histopathological findings in the women with endometrial cancer. Methods: This is a reterospective study of the patients of endometrial cancer from Nov 2011 to Jan 2016 who underwent Surgery (Total abdominal Hystrectomy with B/l salpingoophorectomy with peritoneal washings with b/l pelvic lymphadenectomy with or without para aortic lymphadenectomy) at our centre Max Superspeciality Hospital. CE MRI Pelvis has been done pre operatively in every patient. After the surgery Histopathological reports of the specimen checked and compared with MRI findings of that case. The purpose of the study is to evaluate the validity of MRI findings of endometrial cancer in comparison to final histopathological findings. Results: For the detection of myometrial invasion, overall sensitivity of MRI is 93.9%, specificity is 66.6%, for cervical involvement Senstivity is 60% and specificity 1s 93.75% and for detection of lymph node involvement sensitivity is 66.6% and specificity is 93.5%. Most common Finding on MRI is thickened endometrium with disruption of Junction jone. Conclusions: Preoperative pelvic MRI is a sensitive method of identifying invasion to the myometrium in endometrial cancer. MRI Is a sensitive noninvasive modality in predicting locoregional spread in ca endometrium. Senstivity in detecting Myometrial invasion is high but sensitivity is less in detecting cervical involvement and lymph node involvement is less.

scholarly journals The Utility of CA125 and HE4 in Patients Suffering From Endometrial Cancer

2019 ◽  
Vol 8 (1) ◽  
pp. 95-100
Author(s):  
Narges Zamani ◽  
Mitra Modares Gilani ◽  
Majid Mirmohammadkhani ◽  
Sharzad Sheikhhasani ◽  
Azamsadat Mousavi ◽  
...  
Keyword(s):  
Endometrial Cancer ◽  
Lymph Node ◽  
Preoperative Evaluation ◽  
Myometrial Invasion ◽  
Lymph Node Involvement ◽  
Surgical Staging ◽  
P Value ◽  
Preoperative Serum ◽  
Serum Ca125 ◽  
Node Involvement

Objectives: Uterine endometrial cancer (EC) is the most common female reproductive system malignancy. There are various comments on pelvic and para-aortic lymphadenectomy during the surgical staging of EC. Several oncologists believe that total lymphadenectomy, in some cases, may lead to operative morbidity without any considerable advantage over more surveillance, especially in patients with comorbidities. The purpose of the current study was to examine the correlation between serum tumor marker levels and stage, grade, histological type, myometrial invasion, and lymph node involvement in EC. Materials and Methods: A total of 131 patients with EC participated in the present cross-sectional study. Preoperative serum CA125 and HE4 levels were evaluated 1 week before surgery. Then, the stage, grade, and lymph node involvement were recorded according to the pathological findings. After Data analysis through SPSS software, P value<0.05 was considered to be significant. Results: One hundred thirty-one patients with EC (70, 31, 15, and 15 patients in sequence with stages IA, IB, II, and III) were analyzed. The serum CA125 and HE4 levels were significantly higher in more advanced stages (over IA), (P=0.016 and P=0.004, respectively). Levels of both tumor markers were significantly higher in patients with lymph node involvement, and cervical and myometrial invasions. In logistic regression analysis, a significant correlation was found between HE4 level (odds ratio [OR]=1.005, P=0.035) and grade of disease (OR=2.137, P=0.005). Conclusions: HE4 and CA125 are useful for predicting high-risk patients. Sensitivity of 64% and specificity of 60% were indicated at cut-off value of 70 pmol/L for HE4 in stage IA in comparison with stages over IA. Although the ideal cut-off which is defined as higher than 80% was not obtained, such a cut-off (60%) can also be considered for preoperative evaluation of surgical staging of EC.

scholarly journals Can initial grade of endometrial cancer presenting at Tata Medical Center, predict high risk factors which will require lymph node dissection and adjuvant therapy?

2016 ◽  
Author(s):  
Basumita Chakraborti ◽  
Anik Ghosh ◽  
Jaydip Bhaumik ◽  
Asima Mukhopadhyay
Keyword(s):  
Endometrial Cancer ◽  
Lymph Node ◽  
Adjuvant Therapy ◽  
Medical Center ◽  
Myometrial Invasion ◽  
Lymph Node Involvement ◽  
Pelvic Lymph Node ◽  
Node Dissection ◽  
Node Involvement ◽  
Pelvic Lymph Node Involvement

Background: Pre-operative tumor grade influences the type of surgery planned for endometrial cancer, while the final grade affects the adjuvant therapy. Aims and Objectives: To predict whether pre surgery tumour grade can predict tlymph node dissection and adjuvant therapy in endometriod endometrial cancer. Methods: Retrospective observational study. Data was obtained from electronic hospital medical records system. All women with a diagnosis of endometrioid endometrial cancer who attended TMC, Kolkata between September 2011 and June 2015 included. Review of the histology was asked in all patients and MDT was planned for all patients. Most of the patients operated in TMC underwent standard pre-operative imaging work up like MRI pelvis and CT upper abdomen and chest evaluation. Staging/completion surgery included total hysterectomy, BSO, pelvic +/- para aortic lymphadenectomy +/- Omental biopsy. The surgico-pathological evaluation included histology, grade, myometrial invasion, adnexal involvement and nodal involvement. Results: 155 patients had both initial and final histology. Of total 67 patients with initial grade 1 histology, 8 (12%) were upgraded to G2 and 1 (1.5%) was upgraded to G3. 35 patients with G2 disease 2 (5.7%) were upgraded to G3. Among 8 patients with G3, 7 continued to be G3. Of the 67 patients with initial grade 1, > 50% invasion was seen in 25 (37.3%). Of 35 patients with initial G2, > 50% myometrial invasion was seen in 13 (37.1%) patients. Among 8 initial G3 patients, > 50% invasion was seen in 3 (37.5%) patients. Of these 67 patients with grade 1, pelvic lymph nodes were involved in 4 (6%) patients. None of the grade 2 tumors had pelvic lymph node involvement. One (12.5%) out of 8 patients with initial G3 tumor had pelvic lymph node involvement. Recurrence was seen in 3/67 (4.5%) of G1 patients, 7/35 (20%) with G2 cases and 1/8 (12.5%) with G3 cases. Conclusion: Patients with initial G1 disease, about 13% were upgraded. Recurrence rate increased with G2 patients. For all initial grade tumors the mymetrial involvement > 50% was 37%. For initial G1 patients the pelvic lymph node involvement was found to be 6%. For G3 tumor the pelvic lymph node involvement was 12.5%.

scholarly journals O69: THE SENTINEL LYMPH NODE TECHNIQUE IN THE ENDOMETRIAL CANCER

2021 ◽  
Vol 108 (Supplement_1) ◽  
Author(s):  
H Bouaziz ◽  
S Sghaier ◽  
M Slimane ◽  
L Zabaar ◽  
H Bouzaiene ◽  
...  
Keyword(s):  
Endometrial Cancer ◽  
Lymph Node ◽  
Sentinel Lymph Node ◽  
Predictive Value ◽  
Gynecological Cancer ◽  
Myometrial Invasion ◽  
Pelvic Mri ◽  
Patent Blue ◽  
Paraaortic Lymphadenectomy ◽  
Medicine Physician

Abstract Introduction The sentinel lymph node (SLN) concept represents advancement in the management of the endometrial cancer (EC). We aim to assess the performance of the SLN procedure; its positive predictive value (PPV) and negative predictive value (NPV); in stage I of EC (FIGO2009). Method A prospective study is conducted in our institution. We perform a double detection of the SLN (radiolabel Tc 99 microsulfur colloid and a color method using patent blue) followed by pelvic lymphadenectomy with or without paraaortic lymphadenectomy. A pelvic MRI is performed to determine myometrial invasion and nodal status. The injection of Tc 99m colloid occurs the day prior to surgery. The injection into the stroma of the cervix at the 3 and 9 o'clock positions was performed by an oncologist surgeon with the assistance of a nuclear medicine physician. Preoperative lymphoscintigraphy was obtained after 90-120 minutes. We inject into the cervical stroma 2cc of patent blue similar to the Tc99 injection. A gamma detecting probe is used to locate radioactive lymph nodes. The SLNs identified then are labelled as radioactive and/or blue. No frozen-section analysis was performed. Results For the pathological analysis of the SLN, Haematoxylin Eosin is used. If there is no metastasis detected, an ultra staging protocol using different anti-cytokeratines is conducted. Studies have shown that this approach is possible having satisfactory results when conducted by dedicated surgical, radiology and pathology team. We look forward to our outcomes to illustrate those results. Take-home message Sentinel lymph node is a good alternative for gynecological cancer

scholarly journals Nm23 expression in endometrial and cervical cancer: inverse correlation with lymph node involvement and myometrial invasion

1996 ◽  
Vol 74 (7) ◽  
pp. 1063-1068 ◽  
Author(s):  
M Marone ◽  
G Scambia ◽  
G Ferrandina ◽  
C Giannitelli ◽  
P Benedetti-Panici ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Lymph Node ◽  
Myometrial Invasion ◽  
Inverse Correlation ◽  
Lymph Node Involvement ◽  
Node Involvement

Lymph Node Metastasis in Patients With Endometrioid Endometrial Cancer: Overtreatment Is the Main Issue

2017 ◽  
Vol 27 (4) ◽  
pp. 748-753 ◽  
Author(s):  
Alper Karalok ◽  
Taner Turan ◽  
Derman Basaran ◽  
Osman Turkmen ◽  
Gunsu Comert Kimyon ◽  
...  
Keyword(s):  
Endometrial Cancer ◽  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Histological Grade ◽  
Myometrial Invasion ◽  
Lymph Node Involvement ◽  
Node Metastasis ◽  
Deep Myometrial Invasion ◽  
Endometrioid Endometrial Cancer ◽  
Grade 3

ObjectiveThe aim of this study was to evaluate the effectiveness of histological grade, depth of myometrial invasion, and tumor size to identify lymph node metastasis (LNM) in patients with endometrioid endometrial cancer (EC).MethodsA retrospective computerized database search was performed to identify patients who underwent comprehensive surgical staging for EC between January 1993 and December 2015. The inclusion criterion was endometrioid type EC limited to the uterine corpus. The associations between LNM and surgicopathological factors were evaluated by univariate and multivariate analyses.ResultsIn total, 368 patients were included. Fifty-five patients (14.9%) had LNM. Median tumor sizes were 4.5 cm (range, 0.7–13 cm) and 3.5 cm (range, 0.4–33.5 cm) in patients with and without LNM, respectively (P = 0.005). No LMN was detected in patients without myometrial invasion, whereas nodal spread was observed in 7.7% of patients with superficial myometrial invasion and in 22.6% of patients with deep myometrial invasion (P < 0.0001). Lymph node metastasis tended to be more frequent in patients with grade 3 disease compared with those with grade 1 or 2 disease (P = 0.131).ConclusionsThe risk of lymph node involvement was 30%, even in patients with the highest-risk uterine factors, that is, those who had tumors of greater than 2 cm, deep myometrial invasion, and grade 3 disease, indicating that 70% of these patients underwent unnecessary lymphatic dissection. A precise balance must be achieved between the desire to prevent unnecessary lymphadenectomy and the ability to diagnose LNM.

Uterine Papillary Serous, Clear Cell, and Poorly Differentiated Endometrioid Carcinomas: A Comparative Study

2011 ◽  
Vol 21 (4) ◽  
pp. 661-667 ◽  
Author(s):  
Stefano Greggi ◽  
Giorgia Mangili ◽  
Cono Scaffa ◽  
Felice Scala ◽  
Simona Losito ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
Lymph Node ◽  
Clear Cell ◽  
Myometrial Invasion ◽  
Lymph Node Involvement ◽  
Peritoneal Metastases ◽  
Node Involvement ◽  
Poorly Differentiated ◽  
Independent Risk Factors ◽  
Nuclear Ploidy

Introduction:Uterine papillary serous and clear cell carcinomas (UPSCs/CCs) show a different spreading from that of poorly differentiated endometrioid carcinomas (PDECs) and are usually thought to be prognostically more aggressive than PDECs. On the contrary, it has been recently claimed that UPSC/CC and PDEC have a similar prognosis. In this retrospective study on 2 institutional databases, the surgical-pathological data and survival have been compared in patients with UPSC/CC and PDEC.Methods:A total of 139 surgically staged consecutive patients, 63 with UPSC/CC (37 UPSC; 26 CC) and 76 with PDEC clinically limited to the uterine corpus, have been compared for nuclear ploidy, myometrial invasion, (occult) cervical extension, peritoneal, and lymph node metastasis. Prognostic factors have been correlated through multivariate analysis with survival (disease-specific [DSS] and disease-free [DFS]).Results:Peritoneal metastases and aneuploidy were found to be the only parameters significantly different in the 2 groups: peritoneal metastases 28.6% in UPSC/CC (extrapelvic 19%) and 7.9% in PDEC (extrapelvic 2.6%) (P= 0.001), aneuploidy 48.6% in UPSC/CC and 30.6% in PDEC (P= 0.05). Five-year DSS was 57.9% versus 75.2% (P= 0.02), and DFS was 52.3% versus 71.4% (P= 0.04) for UPSC/CC and PDEC, respectively. All but cervical and lymph node involvement were significant predictors of survival. After multivariate analysis, histotype (DSS: hazard ratio [HR], 1.98; 95% confidence interval [CI], 1.02-3.86;P= 0.04; DFS: HR, 1.94; 95% CI, 1.04-3.63;P= 0.04), stage (DSS: HR, 2.26; 95% CI, 1.10-4.65;P= 0.03; DFS: HR, 2.21; 95% CI, 1.12-4.38;P= 0.02), and myometrial invasion (DSS: HR, 2.86; 95% CI, 1.22-6.69;P= 0.01; DFS: HR, 3.96; 95% CI, 1.63-9.62;P= 0.002) were independent risk factors for survival.Conclusions:Uterine papillary serous and clear cell carcinomas spread to abdominal peritoneum more frequently than PDEC; multivariate analysis confirms UPSC/CC as an independent, unfavorable predictor of outcome.

Prognostic factors of lymph node involvement in endometrioid endometrial cancer: A SEER analysis

2014 ◽  
Vol 133 ◽  
pp. 133
Author(s):  
R. Vargas ◽  
J.A. Rauh-Hain ◽  
J.T. Clemmer ◽  
R.M. Clark ◽  
A. Goodman ◽  
...  
Keyword(s):  
Endometrial Cancer ◽  
Prognostic Factors ◽  
Lymph Node ◽  
Lymph Node Involvement ◽  
Node Involvement ◽  
Endometrioid Endometrial Cancer

Detection of Lymphovascular Invasion by D2-40 (Podoplanin) Immunoexpression in Endometrial Cancer

2012 ◽  
Vol 22 (8) ◽  
pp. 1442-1448 ◽  
Author(s):  
Sarah K. Weber ◽  
Axel Sauerwald ◽  
Martin Pölcher ◽  
Michael Braun ◽  
Manuel Debald ◽  
...  
Keyword(s):  
Overall Survival ◽  
Endometrial Cancer ◽  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Lymphovascular Invasion ◽  
Lymph Node Involvement ◽  
Lymph Vessel ◽  
Node Metastasis ◽  
Lymph Vessel Invasion ◽  
Node Involvement

BackgroundLymph node involvement is a major feature in tumor spread of endometrial cancer and predicts prognosis. Therefore, evaluation of lymph vessel invasion (LVI) in tumor tissue as a predictor for lymph node metastasis is of great importance. Immunostaining of D2-40 (podoplanin), a specific marker for lymphatic endothelial cells, might be able to increase the detection rate of LVI compared with conventional hematoxylin-eosin (H-E) staining. The aim of this retrospective study was to analyze the eligibility of D2-40–based LVI evaluation for the prediction of lymph node metastases and patients’ outcome.Patients and MethodsImmunohistochemical staining with D2-40 monoclonal antibodies was performed on paraffin-embedded tissue sections of 182 patients with primary endometrioid adenocarcinoma treated in 1 gynecologic cancer center. Tumors were screened for the presence of LVI. Correlations with clinicopathological features and clinical outcome were assessed.ResultsImmunostaining of D2-40 significantly increased the frequency LVI detection compared with conventional H-E staining. Lymph vessel invasion was identified by D2-40 in 53 (29.1%) of 182 tumors compared with 34 (18.3%) of 182 carcinomas by routine H-E staining (P = 0.001). D2-40 LVI was detectable in 81.0% (17/21) of nodal-positive tumors and significantly predicted lymph node metastasis (P = 0.001). Furthermore, D2-40 LVI was an independent prognostic factor for patients overall survival considering tumor stage, lymph node involvement, and tumor differentiation (P < 0.01). D2-40–negative tumors confined to the inner half of the myometrium showed an excellent outcome (5-year overall survival, 97.8%).ConclusionsD2-40–based LVI assessment improves the histopathological detection of lymphovascular invasion in endometrial cancer. Furthermore, LVI is of prognostic value and predicts lymph node metastasis. D2-40 LVI detection might help to select endometrial cancer patients who will benefit from a lymphadenectomy.

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