Endometrial cancer: accuracy of the finding of a well differentiated tumorat dilatation and curettage compared to the findings at subsequent hysterectomy

The objective of this study was to examine the accuracy of the finding of a histologically well differentiated endometrial carcinoma at dilatation and curettage (D & C) prior to hysterectomy. A retrospective multicentric char t review of 137 endometrial cancer patients was conducted, including all pa tients in whom a well differentiated endometrial carcinoma had been diagnos ed by D & C. Histopathologic grading as determined by D & C was compared wi th the grading established at the final histologic examination after hyster ectomy. Seventy-eight percent of all cases in which a well differentiated t umor was diagnosed with D & C were confirmed as well differentiated endomet rial carcinomas, whereas 20.4% had to be upgraded as moderately differentia ted tumors after evaluation of the hysterectomy specimen. In one case in wh ich a uterine adenocarcinoma was diagnosed by D & C, a well differentiated adenocarcinoma was found to be combined with a carcinosarcoma in the hyster ectomy specimen. In order to avoid false findings of a well differentiated tumor, the histologic grade should be confirmed by intraoperative frozen se ction examination. This is especially important in cases in which surgical staging was not planned initially.