Stage I Endometrial Carcinoma: Value of MR Imaging in Determining Depth of Myometrial Invasion

Background/Aim. Endometrial carcinoma is the most common malignant neoplasm of the female genital tract in developed countries. Endometrioid carcinoma represents about three-fourths of all endometrial carcinoma. The aim of this study was to examine pathologic parameters, age, and the 5-year survival of the patients with FIGO stage I endometrial carcinoma of endometrioid type and to assess the prognostic utility of age, depth of myometrial invasion, hystologic type (endometrioid or variant), histologic grade, nuclear grade, and lymph-vascular space invasion. Methods. Age, pathologic parameters, and survival data were retrospectively collected on 236 patients with FIGO stage I endometrial carcinoma of endometrioid type. All the patients underwent hysterectomy between 1996 and 2000 and follow-up until December 2005. Results. A total of 236 patients (mean age 58.0, range 40?79) were analyzed. During the 5-year period of follow-up, 59 (25.0%) patents died from the disease. An univariate analysis revealed that age, depth of myometrial invasion, histologic grade, nuclear grade, and lymph-vascular space invasion were associated significantly with the 5-year survival of the patients. A multivariate analysis revealed that age, lymph-vascular space invasion, and depth of myometrial invasion were associated significantly with the 5-year survival. Conclusion. Age, lymph-vascular space invasion, and depth of myometrial invasion are independent prognostic parameters for the 5-year survival of the patients with FIGO stage I endometrial carcinoma of endometrioid type.

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Assessment of depth of myometrial invasion by endometrial carcinoma: comparison of T2-weighted SE and contrast-enhanced dynamic GRE MR imaging

European Radiology ◽

10.1007/s003300050365 ◽

1998 ◽

Vol 8 (2) ◽

pp. 218-223 ◽

Cited By ~ 32

Author(s):

G. Savci ◽

T. Ozyaman ◽

M. Tutar ◽

T. Bilgin ◽

O. Erol ◽

...

Keyword(s):

Mr Imaging ◽

Endometrial Carcinoma ◽

Myometrial Invasion ◽

Contrast Enhanced

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Myometrial invasion by endometrial carcinoma: evaluation with 3.0T MR imaging

Abdominal Imaging ◽

10.1007/s00261-011-9719-8 ◽

2011 ◽

Vol 36 (5) ◽

pp. 612-618 ◽

Cited By ~ 12

Author(s):

Sachi Kaneda ◽

Shinya Fujii ◽

Takeru Fukunaga ◽

Suguru Kakite ◽

Toshio Kaminou ◽

...

Keyword(s):

Mr Imaging ◽

Endometrial Carcinoma ◽

Myometrial Invasion

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MR imaging in endometrial carcinoma as a diagnostic tool for the absence of myometrial invasion

Gynecologic Oncology ◽

10.1016/j.ygyno.2005.12.028 ◽

2006 ◽

Vol 102 (2) ◽

pp. 343-347 ◽

Cited By ~ 68

Author(s):

Yoshifumi Nakao ◽

Masatoshi Yokoyama ◽

Koichi Hara ◽

Yasuko Koyamatsu ◽

Makio Yasunaga ◽

...

Keyword(s):

Mr Imaging ◽

Endometrial Carcinoma ◽

Diagnostic Tool ◽

Myometrial Invasion

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Clinical stage I endometrial carcinoma: pitfalls in preoperative assessment with MR imaging. Work in progress.

Radiology ◽

10.1148/radiology.194.2.7824739 ◽

1995 ◽

Vol 194 (2) ◽

pp. 567-572 ◽

Cited By ~ 66

Author(s):

L M Scoutt ◽

S M McCarthy ◽

S D Flynn ◽

R C Lange ◽

F Long ◽

...

Keyword(s):

Mr Imaging ◽

Endometrial Carcinoma ◽

Clinical Stage ◽

Preoperative Assessment ◽

Stage I ◽

Work In Progress

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Preoperative predictive factor analysis of ovarian malignant involvement in premenopausal patients with clinical stage I endometrioid endometrial carcinoma

10.21203/rs.2.17501/v2 ◽

2020 ◽

Author(s):

Qin Chen ◽

Yan Feng ◽

Wenwen Wang ◽

Weiguo Lv ◽

Baohua Li

Keyword(s):

Endometrial Carcinoma ◽

Clinical Stage ◽

Myometrial Invasion ◽

Stage I ◽

Preoperative Imaging ◽

Invasion Depth ◽

Ca125 Level ◽

Serum Ca125 ◽

Premenopausal Patients ◽

Endometrioid Endometrial Carcinoma

Abstract Background Earlier literature suggests that ovarian preservation in young premenopausal clinical stage I endometrioid endometrial carcinoma patients does not negatively impact prognosis and is a more suitable choice for management of the disease. The main purpose of this study was to clarify the incidence of ovarian malignant involvement in premenopausal clinical stage I endometrioid endometrial carcinoma and further identify potential preoperative predictive factors of ovarian malignant involvement. Methods Premenopausal patients (≤50 years) with clinical stage I endometrioid endometrial carcinoma subjected to total hysterectomy and bilateral salpingo-oophorectomy with or without pelvic and/or para-aortic lymph node dissection at Women’s Hospital, Zhejiang University School of Medicine between 2002 and 2016 were enrolled for study. Patients were excluded in cases of gross extra pelvic disease on examination or imaging and family history of colon or gastrointestinal carcinoma. The included patient population was examined for incidence of ovarian malignant involvement and potential preoperative clinical predictive factors.Results A total of 511 premenopausal (age≤50 years) patients diagnosed with clinical stage I endometrioid endometrial carcinoma were enrolled for the study. Ovarian malignant involvements were detected in 23 of the patients (4.5%). Kaplan-Meier analysis showed poorer prognoses of patients with ovarian malignant involvement than those without ovarian involvement. Univariate and multivariate logistic analysis validated preoperative imaging of myometrial invasion depth, the gross appearance of the ovaries, and preoperative serum carbohydrate antigen 125 (CA125) level as independent risk predictors of postoperative ovarian malignant involvement. Receiver operating characteristic (ROC) curves was individually generated for preoperative myometrial invasion depth, the gross appearance of the ovaries, and serum CA125 level as well as a combination of the three factors. The area under curve (AUC) was 0.858 (95% confidence interval [CI], 0.757–0.960) for the combined three factors.Conclusions The incidence of ovarian malignant involvement in premenopausal patients with clinical stage I endometrioid endometrial carcinoma was relatively minimal. Preoperative imaging of myometrial invasion depth, the gross appearance of the ovaries, and serum CA125 level were independent risk predictors of ovarian malignant involvement. These findings may facilitate preoperative counseling of patients and informed clinical decision-making on ovarian preservation in these patients.

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