Objective: To determine whether pre-operative investigations identify a group of patients with low-risk endometrial cancer, who do not require tertiary referral for surgical staging or pelvic radiotherapy.
Design: Retrospective chart review.
Setting: South Island of New Zealand gynaecological oncology services.
Sample: One hundred and forty consecutive patients with newly diagnosed endometrial cancer from 1988 to 2000.
Methods: The results of preoperative investigations were compared with the final pathology.
Main outcome measures: Correlation of preoperative investigations with low risk disease. For the purpose of the study, women with grade 1 or 2 endometrioid tumours confined to the uterine body and less than 50% myometrial invasion were considered to have low risk disease.
Results: In total, 50 women had low risk disease. Only 53% of patients with grade 1 tumours on initial biopsy had low risk disease. Women who had a grade 1 tumour at biopsy and, an ultrasound report with an endometrial thickness of less than 20 mm, and no evidence of myometrial invasion, cervical involvement or adnexal metastasis had a 76% chance of having low risk disease.
Conclusion: We were unable to accurately define the low risk group from pre-operative assessment.