Significance of true surgical pathologic staging: A gynecologic oncology group study

William T. Creasman, Koen DeGeest, Philip J. DiSaia, Richard J. Zaino

Research output: Contribution to journalArticlepeer-review

55 Scopus citations

Abstract

OBJECTIVE: The object of the study was to determine the true surgical pathologic disease extent in patients with clinical stage II adenocarcinoma of the endometrium. STUDY DESIGN: As part of a Gynecologic Oncology Group surgical pathologic protocol of patients with adenocarcinoma of the endometrium, patients with clinical stage II cancers were evaluated. Among >1000 patients with early stage disease entered into this protocol group study, 148 were in clinical stage II. All patients underwent abdominal hysterectomy, bilateral salpingo-oophorectomy, and selective pelvic and paraaortic lymphadenectomy as the primary therapy. Surgical pathologic material was evaluated to determine true extent of disease. RESULTS: Only 66 of 148 (45%) of patients in clinical stage II had cancer in the cervix. Fifty-seven patients had disease limited to the upper fundus and 25 had disease extending into the lower uterine segment but not into the cervix. Among the 66 patients with disease in the cervix, only 35 had disease limited to the uterus whereas 31 patients had extrauterine disease (lymph nodes, adnexa, etc). Thus among 148 patients with diagnoses of clinical stage II disease only 35 (24%) in fact had true surgical stage II cancer. CONCLUSION: Clinical diagnosis of stage II adenocarcinoma of the uterus is a poor reflection of true surgical stage II cancer. Only when true extent of disease is known can optimally definitive therapy be determined.

Original languageEnglish (US)
Pages (from-to)31-34
Number of pages4
JournalAmerican journal of obstetrics and gynecology
Volume181
Issue number1
DOIs
StatePublished - Jan 1 1999

Keywords

  • Adenocarcinoma of the endometrium
  • Pathologic staging
  • Surgical staging

ASJC Scopus subject areas

  • Obstetrics and Gynecology

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