Comparison of Myometrial Invasion and Tumor Free Distance from Uterine Serosa in Endometrial Cancer

There are many studies assessing the importance of myometrial invasion using a cut-off limit as 50% of myometrial invasion for endometrial cancer, and there are a limited number of studies evaluating tumor-free distance to the serosa. To evaluate the prognostic performance of tumor-free distance and percentage of myometrial invasion in patients with stage IB endometrioid endometrial cancer, we retrospectively evaluated 133 patients diagnosed and treated as stage IB endometrioid endometrial cancer. Tumor-free distance was assessed, and recurrence and recurrence-free survival were analyzed. Nine patients had recurrent disease (6.8%). Recurrence-free survival was 200 months. Two patients died because of malignancy. In the Cox regression model according to tumor-free distance, depth of invasion, and percentage of myometrial invasion, it was seen that none of these parameters were significant to predict the recurrence (p>0.05). In conclusion, tumor-free distance is not an independent prognostic factor for patients with stage IB endometrioid endometrial cancer.

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Tumour-free distance from serosa is a better prognostic indicator than depth of invasion and percentage myometrial invasion in endometrioid endometrial cancer

BJOG An International Journal of Obstetrics & Gynaecology ◽

10.1111/j.1471-0528.2012.03427.x ◽

2012 ◽

Vol 119 (10) ◽

pp. 1162-1170 ◽

Cited By ~ 9

Author(s):

S Chattopadhyay ◽

KA Galaal ◽

A Patel ◽

A Fisher ◽

A Nayar ◽

...

Keyword(s):

Endometrial Cancer ◽

Myometrial Invasion ◽

Prognostic Indicator ◽

Depth Of Invasion ◽

Free Distance ◽

Endometrioid Endometrial Cancer

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Ultrasound Measurement of Tumor-Free Distance from the Serosal Surface as the Alternative to Measuring the Depth of Myometrial Invasion in Predicting Lymph Node Metastases in Endometrial Cancer

Diagnostics ◽

10.3390/diagnostics11081472 ◽

2021 ◽

Vol 11 (8) ◽

pp. 1472

Author(s):

Marcin Liro ◽

Marcin Śniadecki ◽

Ewa Wycinka ◽

Szymon Wojtylak ◽

Michał Brzeziński ◽

...

Keyword(s):

Endometrial Cancer ◽

Lymph Node ◽

Lymph Node Metastases ◽

Transvaginal Ultrasound ◽

Multivariable Analysis ◽

Myometrial Invasion ◽

Ultrasound Measurement ◽

Lymph Node Status ◽

Free Distance ◽

Node Metastases

Background: Ultrasonography’s usefulness in endometrial cancer (EC) diagnosis consists in its roles in staging and prediction of metastasis. Ultrasound-measured tumor-free distance from the tumor to the uterine serosa (uTFD) is a promising marker for these diagnostic and prognostic variables. The aim of the study was to determine the usefulness of this biomarker in locoregional staging, and thus in the prediction of lymph node metastasis (LNM). Methods: We conducted a single-institutional, prospective study on 116 consecutive patients with EC who underwent 2D transvaginal ultrasound examination. The uTFD marker was compared with the depth of ultrasound-measured myometrial invasion (uMI). Univariable and multivariable logit models were evaluated to assess the predictive power of the uTFD and uMI in regard to LNM. The reference standard was a final histopathology result. Survival was assessed by the Kaplan–Meier method. Results: LNM was found in 17% of the patients (20/116). In the univariable analysis, uMI and uTFD were significant predictors of LNM. The accuracy was 70.7%, and the NPV was 92.68% (OR 4.746, 95% CI 1.710–13.174) for uMI (p = 0.002), and they were 63.8% and 89.02% (OR 0.842, 95% CI 0.736–0.963), respectively, for uTFD (p = 0.01). The cutoff value for uTFD in the prediction of LNM was 5.2 mm. The association between absence of LNM and biomarker values of uMI < 1/2 and uTFD ≥ 5.2 mm was greater than that between the presence of metastases and uMI > 1/2 and uTFD values <5.2 mm. In the multivariable analysis, the accuracy of the uMI–uTFD model was 74%, and its NPV was 90.24% (p = non-significant). Neither uMI nor uTFD were surrogates for overall and recurrence-free survivals in endometrial cancer. Conclusions: Both uMI and uTFD, either alone or in combination, were valuable tools for gaining additional preoperative information on expected lymph node status. Negative lymph nodes status was better described by ultrasound biomarkers than a positive status. It was easier to use the uTFD rather than the uMI measurement as a biomarker of EC invasion, and the former still maintained a similar predictive value for lymph node metastases to the latter at diagnosis.

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Evaluation of Tumor-Free Distance and Depth of Myometrial Invasion as Prognostic Factors for Lymph Node Metastases in Endometrial Cancer

International Journal of Gynecological Cancer ◽

10.1111/igc.0b013e3181ef0a31 ◽

2010 ◽

Vol 20 (7) ◽

pp. 1217-1221 ◽

Cited By ~ 15

Author(s):

Srinivas Kondalsamy-Chennakesavan ◽

Stijn van Vugt ◽

Karen Sanday ◽

Jim Nicklin ◽

Russell Land ◽

...

Keyword(s):

Endometrial Cancer ◽

Prognostic Factors ◽

Lymph Node ◽

Lymph Node Metastases ◽

Myometrial Invasion ◽

Free Distance ◽

Node Metastases

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MRI-assessed tumor-free distance to serosa predicts deep myometrial invasion and poor outcome in endometrial cancer

Insights into Imaging ◽

10.1186/s13244-021-01133-z ◽

2022 ◽

Vol 13 (1) ◽

Author(s):

Julie Andrea Dybvik ◽

Kristine E. Fasmer ◽

Sigmund Ytre-Hauge ◽

Jenny Hild Aase Husby ◽

Øyvind O. Salvesen ◽

...

Keyword(s):

Endometrial Cancer ◽

Myometrial Invasion ◽

Imaging Biomarker ◽

Preoperative Imaging ◽

Tumor Diameter ◽

Post Contrast ◽

Pelvic Mri ◽

Free Distance ◽

Deep Myometrial Invasion ◽

Mri Measurements

Abstract Objectives To explore the diagnostic accuracy of preoperative magnetic resonance imaging (MRI)-derived tumor measurements for the prediction of histopathological deep (≥ 50%) myometrial invasion (pDMI) and prognostication in endometrial cancer (EC). Methods Preoperative pelvic MRI of 357 included patients with histologically confirmed EC were read independently by three radiologists blinded to clinical information. The radiologists recorded imaging findings (T1 post-contrast sequence) suggesting deep (≥ 50%) myometrial invasion (iDMI) and measured anteroposterior tumor diameter (APD), depth of myometrial tumor invasion (DOI) and tumor-free distance to serosa (iTFD). Receiver operating characteristic (ROC) curves for the prediction of pDMI were plotted for the different MRI measurements. The predictive and prognostic value of the MRI measurements was analyzed using logistic regression and Cox proportional hazard model. Results iTFD yielded highest area under the ROC curve (AUC) for the prediction of pDMI with an AUC of 0.82, whereas DOI, APD and iDMI yielded AUCs of 0.74, 0.81 and 0.74, respectively. Multivariate analysis for predicting pDMI yielded highest predictive value of iTFD < 6 mm with OR of 5.8 (p < 0.001) and lower figures for DOI ≥ 5 mm (OR = 2.8, p = 0.01), APD ≥ 17 mm (OR = 2.8, p < 0.001) and iDMI (OR = 1.1, p = 0.82). Patients with iTFD < 6 mm also had significantly reduced progression-free survival with hazard ratio of 2.4 (p < 0.001). Conclusion For predicting pDMI, iTFD yielded best diagnostic performance and iTFD < 6 mm outperformed other cutoff-based imaging markers and conventional subjective assessment of deep myometrial invasion (iDMI) for diagnosing pDMI. Thus, iTFD at MRI represents a promising preoperative imaging biomarker that may aid in predicting pDMI and high-risk disease in EC.

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Ultrasound Measurement of Tumor-Free Distance from the Serosal Surface as the Alternative to Measuring the Depth of Myometrial Invasion in Predicting Lymph Node Metastases in Endometrial Cancer

10.20944/preprints202107.0676.v1 ◽

2021 ◽

Author(s):

Marcin Liro ◽

Marcin Śniadecki ◽

Ewa Wycinka ◽

Szymon Wojtylak ◽

Michał Brzeziński ◽

...

Keyword(s):

Endometrial Cancer ◽

Lymph Node ◽

Lymph Node Metastases ◽

Transvaginal Ultrasound ◽

Univariate Analysis ◽

Myometrial Invasion ◽

Ultrasound Measurement ◽

Lymph Node Status ◽

Free Distance ◽

Node Metastases

Background: Ultrasonography’s usefulness in endometrial cancer (EC) diagnosis consists of its staging and predictive roles. Ultrasound-measured tumor-free distance from the tumor to the uterine serosa (uTFD) is a promising marker for this variable. The aim of the study was to determine the usefulness of this biomarker in locoregional staging, and thus in the prediction of lymph node metastasis (LNM). Methods: We conducted a single-institutional, prospective study on 116 consecutive patients with EC who underwent 2D transvaginal ultrasound examination. The uTFD marker was compared with the depth of ultrasound-measured myometrial invasion (uMI). Univariate and multivariate logit models were evaluated to assess the predictive power of the uTFD and uMI in regard to LNM. The reference standard was a final histopathology result. Survival was assessed by the Kaplan-Meyer method. Results: LNM was found in 17% of the patients (20/116). In the univariate analysis, uMI and uTFD were significant predictors of LNM. Accuracy was 70.7%, and NPV was 92.68% (OR 4.746, 95% CI 1.710-13.174) for uMI (p = 0.002), and 63.8%, and 89.02% (OR 0.842, 95% CI 0.736 – 0.963), respectively, for uTFD (p = 0.01). The cut-off value for uTFD in the prediction of LNM was 5.2 mm. The absence of LNM was associated more with biomarker values uMI &lt;1/2 and uTFD &gt;=5.2 mm than with the presence of metastases with uMI &gt;1/2 and uTFD values &lt;5.2 mm. In the multivariate analysis, the accuracy of the uMI-uTFD model was 74%, and NPV was 90.24% (p = NS). Neither uMI nor uTFD are surrogates for overall and recurrence-free survivals in endometrial cancer. Conclusions: Both uMI and uTFD, either alone or in combination, are valuable tools for gaining additional preoperative information on expected lymph node status. Negative lymph nodes status is better described by ultrasound biomarkers than a positive status. It is easier to use uTFD measurement as a biomarker of EC invasion than uMI, and the former still maintains a similar predictive value for lymph node metastases to the latter at diagnosis.

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

10.1055/s-0039-1685340 ◽

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.

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PET Parameters are Useful in Predicting Endometrial Cancer Risk Classes and Prognosis

Nuklearmedizin ◽

10.1055/a-1267-8976 ◽

2020 ◽

Author(s):

Adnan Budak ◽

Emrah Beyan ◽

Abdurrahman Hamdi Inan ◽

Ahkam Göksel Kanmaz ◽

Onur Suleyman Aldemir ◽

...

Keyword(s):

Endometrial Cancer ◽

High Risk ◽

Myometrial Invasion ◽

Risk Groups ◽

Total Sample ◽

Tumor Stage ◽

Low Risk ◽

Tumor Diameter ◽

Grade 3 ◽

Fdg Pet Ct

Abstract Aim We investigate the role of preoperative PET parameters to determine risk classes and prognosis of endometrial cancer (EC). Methods We enrolled 81 patients with EC who underwent preoperative F-18 FDG PET/CT. PET parameters (SUVmax, SUVmean, MTV, TLG), grade, histology and size of the primary tumor, stage of the disease, the degree of myometrial invasion (MI), and the presence of lymphovascular invasion (LVI), cervical invasion (CI), distant metastasis (DM) and lymph node metastasis (LNM) were recorded. The relationship between PET parameters, clinicopathological risk factors and overall survival (OS) was evaluated. Results The present study included 81 patients with EC (mean age 60). Of the total sample, 21 patients were considered low risk (endometrioid histology, stage 1A, grade 1 or 2, tumor diameter < 4 cm, and LVI negative) and 60 were deemed high risk. All of the PET parameters were higher in the presence of a high-risk state, greater tumor size, deep MI, LVI and stage 1B-4B. MTV and TLG values were higher in the patients with non-endometrioid histology, CI, grade 3 and LNM. The optimum cut-off levels for differentiating between the high and low risk patients were: 11.1 for SUVmax (AUC = 0.757), 6 for SUVmean (AUC = 0.750), 6.6 for MTV(AUC = 0.838) and 56.2 for TLG(AUC = 0.835). MTV and TLG values were found as independent prognostic factors for OS, whereas SUVmax and SUVmean values were not predictive. Conclusions The PET parameters are useful in noninvasively differentiating between risk groups of EC. Furthermore, volumetric PET parameters can be predictive for OS of EC.

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