The role of preoperative routine computed tomography scanning in the estimation of high- risk factors in endometrial cancers

Objective: To examine the role of preoperative computed tomography (CT) in estimation of the high-risk factors in endometrial cancer cases. Materials and Methods: The data from 161 cases who were diagnosed with endometrioid adenocarcinoma with endometrial biopsy, and staged surgically were retrospectively analyzed. The diagnostic performance of a whole abdominal CT scan in terms of tumor diameter, myometrial invasion, cervical, adnexal, omental involvement, as well as pelvic para-aortic nodal involvement was examined. In addition, extra-uterine and extra-nodal incidental signs were identified. Results: The accuracy rate of preoperative CT scanning was found to be 42%, 78%, 80%, 95%, 97%, 88%, 89%, and 88% for tumor diameter, myometrial invasion, cervical, adnexal, and omental involvement, as well as pelvic para-aortic nodal involvement, respectively. Extra-uterine and extra-nodal incidental signs were identified in 18% of the cases. Incidental findings entailed a modification of management only in one case (0.62%). Conclusion: Preoperative CT scan findings do not present an alternative to intraoperative frozen section analysis or surgical staging. However, based on the findings from the preoperative CT scan, accuracy of predictions about which patients require more complex procedures (lymphadenectomy) can be improved, and therefore preoperative CT scanning may prove useful in more effective use of operating rooms.

Computed Tomography; Endometrioid endometrial cancer; Imaging.

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