JCOGP
Journal of Controversies in Obstetrics & Gynecology and Pediatrics

As of January 2023, our "Journal of Controversies Obstetrics & Gynecology and Pediatrics" has been published under the Medihealth Academy to publish all articles, reviews and case reports on Pediatrics, especially in the field of Obstetrics and Gynecology. In order to facilitate the citation of the articles, to take our place in internationally respected indexes and to reach a wider readership, we will pay attention to the fact that our article language is only English in terms of acceptance.

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Original Article
Prediction of preoperative and postoperative FIGO grade concordance in patients with endometrial cancer
Abstract
Aims: To determine the factors leading to upgrading in the final pathology result in cases with endometrial cancer.
Methods: We retrospectively analyzed the records of patients with endometrioid endometrial adenocarcinoma to evaluate the concordance between FIGO grade in preoperative endometrial sampling and postoperative final pathology grade. As a result of endometrial sampling, FIGO grade was reported as up-grading if it was lower than final pathology report, and as down-grading, if it was higher than final pathology report. The effects of tumor size, degree of myometrial invasion, lymphovascular invasion, FIGO stage, tumor localization, and additional uterine/endometrial pathologies on up-grading were evaluated.
Results: A total of 151 patients remained eligible for final analysis. The overall down-grading percentage was 8.6%, and the up-grading percentage was 25.2%. In preoperative endometrial sampling, the up-grading rates for FIGO grades 1 and 2 were analyzed as 30.5% and 20.0%. The concordance rates between preoperative endometrial sampling results and postoperative definitive pathology results were calculated as 69.5%, 55.6%, and 81.8% for FIGO grade 1,2,3, respectively.It was found that patients with more than 50% myometrial invasion (p=0.048), and those with advanced FIGO stages were more up-grading than those with earlier stages (p=0.005).
Conclusion: There is a substantial difference between the grade of preoperative endometrial sampling material and the postoperative final pathology grade in patients with endometrioid-type endometrial cancer.In the preoperative evaluation, assessment of additional markers in combination with magnetic resonance imaging may reduce misconceptions in the diagnosis, given that 25% of the patients were up-grading.

Keywords : Endometrial adenocarcinoma, endometrial sampling, FIGO grade, preoperative pathology, up-grading

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1. Sung H, Ferlay J, Siegel RL, et al. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries.CA Cancer J Clin. 2021;71(3):209-249.
2. Kurman RJ, Carcangiu ML, Herrington CS, et al. Tumours of the uterine corpus. WHO classification of tumours of female reproductive organs. 4thed. Lyon, France: IARCH; 2014. p. 121-54.
3. Shiozaki T, Miwa M, Sakuma T, et al. Correlation between pre-operative and final histological diagnosis on endometrial cancer. Int J Gynecol Cancer.2019;29(5):886-889.
4. Clarke BA, Gilks CB. Endometrial carcinoma: controversies in histopathological assessment of grade and tumour cell type. J Clin Pathol. 2010;63(5):410-415.
5. Tanaka K, Kobayashi Y, Sugiyama J, et al. Histologic grade and peritoneal cytology as prognostic factors in type 1 endometrial cancer. Int J Clin Oncol. 2017;22(3):533-540.
6. Piotto MASB, Focchi GRA, Marques RM, et al. Assessment of preoperative endometrial histopathological sampling as a predictor of final surgical pathology in endometrial cancer. Rev Bras Ginecol Obstet. 2020;42(10):642-648
7. Franchi M, Ghezzi F, Riva C, et al. Postoperative complications after pelvic lymphadenectomy for the surgical staging of endometrial cancer. J Surg Oncol. 2001;78(4):232-240.
8. Petersen RW, Quinlivan JA, Casper GR, et al. Endometrial adenocarcinoma-presenting pathology is a poor guide to surgical management. Australia NZ J Obstetrics Gynaecol. 2000;40(2):191-194.
9. Wang X, Huang Z, Di W, et al. Comparison of D&C and hysterectomy pathologic findings in endometrial cancer patients. Arch Gynecol Obstet. 2005;272(2):136-141.
10. Francis JA, Weir MM, Ettler HC, et al. Should preoperative pathology be used to select patients for surgical staging in endometrial cancer? Int J Gynecol Cancer. 2009;19(3):380-384.
11. Ben-Shachar I, Pavelka J, Cohn DE, et al.Surgical staging for patients presenting with grade 1 endometrial carcinoma. Obstet Gynecol. 2005; 105(3):487-493.
12. Cohn DE, Huh WK, Fowler JM, et al. Cost-effectiveness analysis of strategiesfor the surgical management of grade 1 endometrial adenocarcinoma. Obstet Gynecol. 2007;109(6):1388-1395.
13. Eltabbakh GH, Shamonki J, Mount SL. Surgical stage, final grade, and survival of women with endometrial carcinoma whose preoperative endometrial biopsy shows well-differentiated tumors.Gynecol Oncol. 2005; 99(2):309-312.
14. Akış S, Kabaca C, Keleş E, et al. Tumor diameter as a predictor of lymph node involvement in endometrioid type endometrial adenocarcinomas. J Obstet Gynaecol Res. 2021;47(11):3968-3978.
15. Doghri R, Chaabouni S, Houcine Y, et al. Evaluation of tumor-free distance and depth of myometrial invasion as prognostic factors in endometrial cancer. Mol Clin Oncol. 2018;9(1):87-91.
16. Yan B, Liang X, Zhao T, et al. Is the standard deviation of the apparent diffusion coefficient a potential tool for the preoperative prediction of tumor grade in endometrial cancer? Acta Radiol. 2020;61(12):1724-1732.
17. Chung HH, Kang SB, Cho JY, et al. Accuracy of MR imaging for the prediction of myometrial invasion of endometrial carcinoma. Gynecol Oncol. 2007;104(3):654-659.
18. Keles E, Akış S, Özyürek Ş, et al. How specific are CA-125 levels in ruling out extra-uterine extension of endometrial serous papillary cancer? JGON. 2022;19(2):1255-1259.
19. Asami Y, Hiranuma K, Takayanagi D, et al. Predictive model for thepreoperative assessment and prognostic modeling of lymph nodemetastasis in endometrial cancer. Sci Rep. 2022;12(1):19004.
20. Case AS, Rocconi RP, Straughn JM Jr, et al. A prospective blindedevaluation of the accuracy of frozen section for the surgical managementof endometrial cancer. Obstet Gynecol. 2006;108(6):1375-1379.
21. Sanjuán A, Cobo T, Pahisa J, et al. Preoperative and intraoperativeassessment of myometrial invasion and histologic grade in endometrialcancer: role of magnetic resonance imaging and frozen section. Int JGynecol Cancer. 2006;16(1):385-390.
Article available in :
Volume 3, Issue 1, 2025
Page : 9-13
https://doi.org/10.51271/JCOGP-0040
Article Information
Received : 19 Eyl 2024
Accepted : 17 Eki 2024
Published : 09 Oca 2025
Corresponding Author :

İsmail Bağlar: Department of Obstetrics and Gynecology, University of Health Sciences, Kartal Lütfi Kırdar City Hospital, İstanbul, Turkiye

[email protected]
Citation : Öztürk UK, Akis S, Keleş E, et al. Prediction of preoperative and postoperative FIGO grade concordance in patients with endometrial cancer. J Controv Obstetr Gynecol Ped. 2025;3(1):9-13.

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