Preop Endometrial Sampling Detects High-Grade Tumors

NEW YORK APR 02, 2007 Reuters Health) - Preoperative endometrial sampling is effective in accurately diagnosing high-grade endometrial tumors, New York-based researchers report in the March issue of the American Journal of Obstetrics & Gynecology.

The Pipelle is the most accurate device for office endometrial sampling, note Dr. Gloria S. Huang, of Montefiore Medical Center in the Bronx, and colleagues.  However, she told Reuters Health that "we noted a lack of data in the literature about the ability of endometrial sampling to detect these aggressive types of endometrial cancer."

The researchers conducted a retrospective study of 360 women who underwent preoperative endometrial sampling and then had hysterectomy specimens reviewed.

The sensitivity of Pipelle in patients with low-grade cancers was 93.8%. For high-grade cancer, it was 99.2%. For curettage, the corresponding values were 97% and 100%.

The team also observed good agreement between the preoperative samples and the hysterectomy specimens in terms of histologic diagnoses and tumor grades.

Overall, the investigators report, the Pipelle approach performed well in detecting high-grade and non-endometrioid tumor types. Furthermore, "the accuracy of the endometrial sample in predicting the final histology and grade," they conclude, "may be useful for guiding the preoperative counseling and management of patients undergoing surgery for endometrial cancer."

The optimal management of these patients, Dr. Huang said, "includes comprehensive surgical staging to assess the extent of the cancer."

"Our findings substantiate the importance of involving a gynecologic oncologist in the management of all patients with a diagnosis of endometrial cancer," she added.

SOURCE:

• Am J Obstet Gynecol 2007;196:243e1-243e5.