Background and Objectives: Intraoperative evaluation of the uterus has been reported to predict risk of lymph node spread in endometrial cancer.Four criteria have been prospectively validated by the Mayo Clinic; histopathology, grade, tumor size, and depth of myometrial invasion.The objective of this study is to assess the accuracy of intraoperative evaluation in a university-affiliated teaching setting.Methods: This study was a retrospective chart review of 105 cases of endometrial cancer who underwent roboticassisted staging from January 2016 through December 2017.Results: Seventy-five cases were included.The mean age was 65 y and mean body mass index was 33 kg/m 2 .Fifty-eight patients (80.6%) had no change between intraoperative and postoperative grade.This yielded a 19.4% discordance rate with a significant disagreement (P ϭ .003,Cohen's ϭ 0.705).Fifty-eight patients (82.9%) had no change in depth of invasion.This yielded a 17.1% discordance rate with a significant disagreement (P ϭ .0498,Cohen's kappa of 0.69 [95% confidence interval, 0.53-0.85]).Average tumor diameter was 3.4 cm.Seven patients (11.7%) were upsized from the low-risk (Յ2 cm) to the high-risk category (Ͼ2 cm).This led to an 11.7% discordance rate, with a significant disagreement (P ϭ .008,Cohen's kappa of 0.69 [95% confidence interval, 0.48 -0.89]).In 15 of 75 cases (20%), intraoperative evaluation of the size of the tumor was not possible and deferred to the final pathology report. Conclusion:We conclude the Mayo Clinic Criteria cannot be universally adopted until all four criteria can be validated through a prospective study that includes institutions that have variable resources.
No takes yet. Share an insight, caveat, or question.
Giglio et al. (2020) studied this question.