Selection of patients with high risk endometrial cancer for surgical staging according to the evaluation of pre- And intraoperative risk factors

Paolo Sala, Eva Moran, Roberta Paolucci, Stefania Menoni, Ezio Fulcheri, Sergio Costantini, Mario Valenzano Menada

Research output: Contribution to journalArticle

Abstract

BacKground: The aim of this paper was to assess the accuracy of frozen sections histological examination and preoperative CA-125 to select patients with high risk endometrial cancer. Methods: We reviewed women with type I endometrial cancer treated from January 2011 through January 2013 at the same university hospital. Preoperative CA-125 and intraoperative frozen sections were analyzed to select patients at high risk for metastases, according to Mayo Clinic algorithm. All patients underwent hysterectomy with bilateral adnexectomy. High risk patients underwent complete surgical staging. Respectively, we compared the accuracy of CA-125, frozen sections, and an algorithm combining Ca-125 plus frozen sections, with permanent sections histology as positive control. χ2 test, Landis and Koch kappa statistics (k), sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy were determined for each variable. Results: One hundred seventy-two women were included. CA-125 levels, using 8.3 U/ml as cut-off value, showed 63.4% sensitivity, 51.6% specificity, 84.7% PPV, 25.0% NPV, 61.1% accuracy, and a low kappa statistics (k=0.106, P

Original languageEnglish
Pages (from-to)21-28
Number of pages8
JournalMinerva Ginecologica
Volume68
Issue number1
Publication statusPublished - Feb 1 2016

Keywords

  • CA-125 antigen
  • Endometrial neoplasms
  • Frozen sections
  • Lymph node excision
  • Lymphatic metastasis risk

ASJC Scopus subject areas

  • Obstetrics and Gynaecology

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