Detalle Publicación


Ultrasound characteristics of endometrial cancer as defined by International Endometrial Tumor Analysis (IETA) consensus nomenclature: prospective multicenter study

Autores: Epstein, E. (Autor de correspondencia); Fischerova, D.; Valentin, L.; Testa, A. C. ; Franchi, D.; Sladkevicius, P. ; Fruhauf, F.; Lindqvist, P. G.; Mascilini, F. ; Fruscio, R.; Haak, L. A.; Opolskiene, G.; Pascual, M. A.; Alcázar Zambrano, Juan Luis; Chiappa, V. ; Guerriero, S.; Carlson, J. W.; Van Holsbeke, C. ; Leone, F. P. G.; De Moor, B.; Bourne, T. ; van Calster, B. ; Installe, A. ; Timmerman, D.; Verbakel, J. Y. ; Van den Bosch, T.
ISSN: 0960-7692
Volumen: 51
Número: 6
Páginas: 818 - 828
Fecha de publicación: 2018
Objective To describe the sonographic features of endometrial cancer in relation to tumor stage, grade and histological type, using the International Endometrial Tumor Analysis (IETA) terminology. Methods This was a prospective multicenter study of 1714 women with biopsy-confirmed endometrial cancer undergoing standardized transvaginal grayscale and Doppler ultrasound examination according to the IETA study protocol, by experienced ultrasound examiners using high-end ultrasound equipment. Clinical and sonographic data were entered into a web-based database. We assessed how strongly sonographic characteristics, according to IETA, were associated with outcome at hysterectomy, i.e. tumor stage, grade and histological type, using univariable logistic regression and the c-statistic. Results In total, 1538 women were included in the final analysis. Median age was 65 (range, 27-98) years, median body mass index was 28.4 (range 16-67) kg/m(2), 1377 (89.5%) women were postmenopausal and 1296 (84.3%) reported abnormal vaginal bleeding. Grayscale and color Doppler features varied according to grade and stage of tumor. High-risk tumors, compared with low-risk tumors, were less likely to have regular endometrial-myometrial junction (difference of -23%; 95% CI, -27 to -18%), were larger (mean endometrial thickness; difference of +9%; 95% CI, +8 to +11%), and were more likely to have non-uniform echogenicity (difference of +7%; 95% CI, +1 to +13%), a multiple, multifocal vessel pattern (difference of +21%; 95% CI, +16 to +26%) and a moderate or high color score (difference of +22%; 95% CI, +18 to +27%). Conclusion Grayscale and color Doppler sonographic features are associated with grade and stage of tumor, and differ between high- and low-risk endometrial cancer. Copyright (c) 2017 ISUOG. Published by John Wiley & Sons Ltd.