Utilidad de la Resonancia Magnética en la estadificación preoperatoria del cáncer de endometrio

Abstract

Endometrial cancer is the third most frequent gynecological tumor in our country, Argentina. The later the diagnosis, the lower the survival rate of these patients, reaching 95% in early stages, 69% in locally advanced tumors, and 16.8% when metastasis with distant spread are detected. The aim of this study was to evaluate the usefulness of magnetic resonance imaging (MRI) in pre-surgical staging of endometrial cancer in menopausal patients with previous diagnosis, and to compare these results with surgical and anatomo-pathological findings (APF).

A retrospective cross-sectional study was performed based on the records of patients who attended a private hospital in Cordoba city between 2018 and 2022. Pre-surgical MR findings were staged and categorized according to the guidelines of the International Federation of Gynecology and Obstetrics (FIGO) and correlated with APF. Tables of absolute and relative frequencies were performed and sensitivity/specificity values were calculated for MRI, FIGO and APF.

A total sample of 28 patients with average age of 66±8 years (range= 47-77 years) was studied. The most frequent reason for consultation was genitorrhea (71%). Twenty-nine tumors were detected, with the following histological types: 22 endometrioid adenocarcinomas, 4 papillary serous adenocarcinomas, 2 mixed Müllerian carcinosarcomas, and 1 clear cell adenocarcinoma.

Based on the FIGO MRI staging, 4 tumors were stage IA, 7 stage IB, 6 stage II, 10 stage III, and 2 stage IV. MRI presented sensitivity  of 76.4%, specificity  of 91.6%, positive predictive value: 92%, and negative predictive value:73%, when correlating its results with APF.

In conclusion, MRI is an accurate diagnostic method for pre-surgical staging of endometrial carcinoma, and can be used for treatment planning.