ACCURACY OF PREOPERATIVE HISTOLOGY AND MACROSCOPIC ASSESSMENT OF CERVICAL INVOLVEMENT IN ENDOMETRIAL CARCINOMA

Objective: To compare the diagnostic accuracy between the preoperative ly and macroscopically established determination of cervical involveme nt in endometrial carcinoma. Study design: During the period 1987 to 1 991, 154 patients with endometrial cancer were evaluated in a retrospe ctive blind manner with the objective of assessing the diagnostic accu racy of the preoperative (prehysterectomy curettage) and the macroscop ic (sectioned surgical specimen) determination of the involvement of t he cervix. The results were compared with the histological findings of the hysterectomy specimen (gold standard). Results: Preoperative pre- hysterectomy curettage established a sensitivity of 38% and a specific ity of 91% whereas the macroscopic findings (gross appearance) confirm ed a sensitivity of 50% and a specificity of 95%. A prevalence of 17% for cervical involvement was found. In patients with cervical involvem ent diagnosed on pre-hysterectomy curettage, a positive predictive val ue of 45% and negative predictive value of 88% were established. A pos itive predictive value of 68% and a negative predictive value of 90% r esulted from the judgement of the cervical gross appearance. Conclusio ns: We conclude that the cervical involvement of endometrial carcinoma diagnosed on pre-hysterectomy tissue is less predictive than the judg ement of the intraoperative gross appearance of the cervix. (C) 1997 E lsevier Science Ireland Ltd.