Tratamiento quirúrgico del cáncer de endometrio: ¿qué pasaría si no realizamos biopsia intraoperatoria?

Objectives

To analyse differences between preoperative and postoperative staging in a series of patients with endometrial cancer who underwent surgery in our department.

Material and methods

We conducted a retrospective study of malignant endometrial tumours treated by laparoscopic surgery between January 1^st 2005 and August 31^st 2014. We calculated the sensitivity, specificity, positive predictive value and negative predictive value of magnetic resonance imaging and biopsy performed before the intervention. We estimated the percentage of women at risk of over- and under-treatment if intraoperative biopsy had not been performed.

Results

We included 174 malignant endometrial tumours. The sensitivity, specificity, positive predictive value and negative predictive value of magnetic resonance imaging was 95.09, 63.33, 93.37 and 70.37%, respectively. For preoperative biopsy, the results were sensitivity (90.91%), specificity (65.38%), positive predictive value (74.77%) and negative predictive value. (86.44%). If intraoperative biopsy had not been performed, 12 of 166 (12.65%) women in stage 1 would have been undertreated and 3.61% would have been overtreated.

Conclusion

Intraoperative biopsy should be mandatory in the early the stages of endometrial cancer to avoid under- and over-treatment.