Oncological safety of hysteroscopy in endometrial cancer
Por:
Quintana-Berto, R, Padilla-Iserte, P, Gil-Moreno, A, Oliver-Perez, R, Coronado, P, Martin-Salamanca, M, Pantoja-Garrido, M, Lorenzo, C, Cazorla, E, Gilabert-Estelles, J, Sanchez, L, Roldan-Rivas, F, Diaz-Feijoo, B, Rodriguez-Hernandez, J, Marcos-Sanmartin, J, Muruzabal, J, Canada, A and Domingo, S
Publicada:
1 nov 2022
Ahead of Print:
1 jul 2022
Resumen:
Objective It has been suggested that the manipulation of neoplastic tissue during hysteroscopy may lead to dissemination of tumor cells into the peritoneal cavity and worsen prognosis and overall survival. The goal of this study was to assess the oncological safety comparing hysteroscopy to Pipelle blind biopsy in the presurgical diagnosis of patients with endometrial cancer. Methods We performed a retrospective multicentric study among patients who had received primary surgical treatment for endometrial cancer. A multivariate statistical analysis model was used to compare relapse and survival rates in patients who had been evaluated preoperatively either by hysteroscopy or Pipelle biopsy. The relapse rate, disease-free survival, and overall survival were assessed as the main outcomes. The histological type, tumor size, myometrial invasion, International Federation of Gynecology and Obstetrics (FIGO) stage, surgical approach, use of a uterine manipulator, and adjuvant treatment were also included in the analysis. Results A total of 1731 women from 15 centers were included: 1044 in the hysteroscopy group and 687 in the Pipelle sampling group. 225 patients relapsed during the 10 year follow-up period: 139 (13.3%) in the hysteroscopy group and 86 (12.4%) in the Pipelle sampling group. There is no evidence of an association between the use of hysteroscopy as a diagnostic method and relapse rate (HR 1.24, 95% CI 0.92 to 1.66; p=0.16), lower disease-free survival (HR 1.23, 95% CI 0.92 to 1.66; p=0.15), or overall survival (HR 0.95, 95% CI 0.70 to 1.29; p=0.76). Conclusion Hysteroscopy is a safe diagnostic method for patients with endometrial cancer with no impact on oncological outcomes when compared with sampling by Pipelle.
Filiaciones:
Quintana-Berto, R:
La Fe Univ, Dept Gynecol Oncol, Valencia, Spain
Polytech Hosp, Valencia, Spain
Padilla-Iserte, P:
La Fe Univ, Dept Gynecol Oncol, Valencia, Spain
Polytech Hosp, Valencia, Spain
Gil-Moreno, A:
Univ Autonoma Barcelona, Hosp Univ Vall dHebron, Gynecol Dept, Gynecol Oncol Unit, Barcelona, Spain
Oliver-Perez, R:
Univ Hosp 12 Octubre, 12 Octubre Res Inst, Dept Obstet & Gynecol, Gynecol Oncol Unit, Madrid, Spain
Coronado, P:
Univ Complutense, Hosp Clin San Carlos, Womens Hlth Inst, IdISSC, Madrid, Spain
Martin-Salamanca, M:
Hosp Univ Getafe, Gynecol Dept, Getafe, Spain
Pantoja-Garrido, M:
Univ Hosp Virgen Macarena, Dept Gynecol & Obstet, Seville, Spain
Lorenzo, C:
Hosp Nuestra Senora de la Calendaria, Dept Obstet & Gynecol, Tenerife, Spain
Cazorla, E:
Hosp Univ Torrevieja, Dept Obstet & Gynecol, Torrevieja, Spain
Gilabert-Estelles, J:
Univ Gen Hosp Valencia, Dept Obstet & Gynecol, Valencia, Spain
Sanchez, L:
Univ Gen Hosp Ciudad Real, Gynaecol & Obstet Dept, Castilla La Mancha, Spain
Roldan-Rivas, F:
Clin Lozano Blesa Hosp, Dept Obstet & Gynaecol, Zaragoza, Spain
Diaz-Feijoo, B:
Univ Barcelona, Hosp Clin Barcelona, Inst Clin Gynecol Obstet & Neonatol, Inst Invest Biomed August Pi & Sunyer IDIBAPS, Barcelona, Spain
Rodriguez-Hernandez, J:
Virgen de la Arrixaca Univ Hosp, Gynaecol & Obstet Dept, Murcia, Spain
:
Hosp Gen Univ Alacant, Dept Obstet & Gynecol, Alicante, Spain
Muruzabal, J:
Complejo Hosp Navarra, Dept Gynecol Oncol, Pamplona, Spain
Canada, A:
Hlth Res Inst La Fe Valencia Spain, Dept Biostat, Valencia, Spain
Domingo, S:
La Fe Univ, Dept Gynecol Oncol, Valencia, Spain
Polytech Hosp, Valencia, Spain
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