The Use of Transvaginal Ultrasound in Type II Endometrial Cancer. Issue 5 (June 2015)

• Record Type: Journal Article
• Authors: Billingsley, Caroline C.; Kenne, Kimberly A.; Cansino, Catherine D.; Backes, Floor J.; Cohn, David E.; O'Malley, David M.; Copeland, Larry J.; Fowler, Jeffrey M.; Salani, Ritu
• Is Part Of: International journal of gynecological cancer. Volume 25:Issue 5(2015:Jun.)
• Publication Date: 2015-06
• Subjects: Endometrial cancer -- Endometrial stripe -- Type II, Pelvic ultrasound; Generative organs, Female -- Cancer -- Periodicals; 616.99465
• DOI: 10.1097/IGC.0000000000000423
• Languages: English
• ISSNs: 1048-891X

Abstract

Abstract : Objective: To determine the use of the transvaginal ultrasound (TVUS) in postmenopausal women with type II endometrial cancer. Methods/Materials: A retrospective review was conducted for 173 women with pathology proven type II endometrial cancer at a single institution. Those who underwent preoperative TVUS were included, and the following data were obtained: endometrial stripe (EMS) measurement, uterine and/or adnexal findings, and uterine size/volume. Clinicopathologic factors were abstracted. Descriptive and regression analyses were performed. Results: Fifty-eight women comprised the cohort, and the median age was 66.5 years (50–85 years). The most commonly reported symptom was postmenopausal bleeding in 53 patients (91.4%). The EMS was reported as thin (⩽5mm) or indistinct in 16 patients (27.5%). Approximately 60% of patients had 1 or more ultrasound abnormalities: intracavitary mass (31%), intracavitary fluid (12.1%), myometrial lesion (31.03%), and adnexal mass (12.1%). Poorly differentiated endometrioid cancer (53.45%) represented the predominant histology. Of the 16 (27.5%) women with a thin/indistinct EMS, 5 women (8.6%) did not have any abnormal ultrasound findings whatsoever. Conclusions: Women with type II endometrial cancer had a thin/indistinct EMS on TVUS in approximately 25% of cases. Lack of any ultrasound abnormality, including a thickened EMS, was noted in approximately 10% of patients. The use of TVUS, which has been of value in type I cancer, is limited in type II endometrial cancer. Therefore, endometrial sampling should be included in the evaluation of all women with postmenopausal bleeding, regardless of EMS thickness.