Comparison of the Efficacy of Fractionated Curettage and LEEP in Determin-ing Cervical Canal Involment in Endometrial Cancer

Abstract

Background: The aim of this study is to determine the effectiveness of the LEEP (Loop Electrosurgical Excision Procedure) procedure in the preoperative evaluation of cervical involvement in endomet-rial cancer and to evaluate its contribution to the planning of the surgical procedure. Materials and Methods: 75 patients who were examined prospectively and whose histopathological results were compatible with endometrial cancer were divided into two groups to undergo endo-cervical curettage and LEEP. All patients underwent simple hysterectomy/radical hysterectomy and a surgical staging procedure including pelvic, para-aortic lymph node sampling, omentectomy, and cytology collection. Staging was done according to the FIGO 2009 surgical staging system. The aim was to determine the accuracy rates, sensitivity and specificity in determining cervical involvement by comparing the histopathological findings obtained from the preoperative ECC (Endecervical Cu-rettage) and LEEP procedures of the patients with the operation pathologies. Results: When the pathology results of endocervical curettage samples were compared with the operation pathologies, it was determined that it was statistically significant, but the accuracy rate was 58.7%. When the samples taken from the patients who underwent the LoopElectrosurgicalExci-sion procedure were compared with the surgical pathologies, it was found to be statistically signifi-cant and the accuracy rate was found to be 93.5% (p = 0.037). Conclusions: Determining cervical involvement with the LEEP procedure is superior to the frequ-ently applied endocervical curettage in terms of specificity, positive predictivity and accuracy.

Endometrium Kanserinde Servikal Kanal Tutulumunu Belirlemede Fraksiyoneküretaj ve LEEP’in Etkinliğinin Karşılaştırılması

Abstract

Amaç: Bu çalışmanın amacı, endometrium kanserinde servikal tutulumun preoperatif değer-lendirilmesinde LEEP(Loop Electrosurgical Excision Procedure) işleminin etkinliğinin saptanması ve yapılacak olan cerrahi prosedürün planlanmasına katkısını değerlendirmektir. Materyal ve metod: Prospektif olarak incelenen ve histopatolojik sonuçları endometrial kanserle uyumlu gelen 75 hasta endoservikal kürejaj ve LEEP yapılmak üzere iki guruba ayrıldı. tüm hastalara basit histerektomi/radikal histerktomi ve pelvik, paraaortik lenf nodu örnekleme, omentektomi, sitoloji alımını içeren cerrahi evreleme prosedürü uygulandı. Evreleme FIGO 2009 cerrahi evreleme sistemine göre yapıldı. Hastaların preoperatif uygulanan ECC ve LEEP prosedürlerinden elde edilen histopatolojik bulgular, operasyon patolojileriyle karşılaştırılarak, servikal tutulumu belirlemedeki doğruluk oranları, sensitivite ve spesivitelerinin belirlenmesi amaçlandı. Bulgular: Endoservikal küretaj örneklerinin patoloji sonuçlarıyla operasyon patolojileri karşılaştırıldı-ğında istatiksel olarak anlamlı olduğu, fakat doğruluk oranının 58.7% olduğu belirlendi. Loop Electro-surgical Excision procedure uygulanan Hastalardan alınan örnekler ameliyat patolojileriyle karşılaştı-rıldığında istatiksel olarak anlamlı olduğu saptandı ve doğruluk oranının %93.5 olduğu görül-dü(p=0.037). Sonuç: LEEP işlemi ile servikal tutulumu belirleme, sıklıkla uygulanmakta olan endoservikal küretaja spesivite, pozitif prediktivite ve doğruluk oranı açısından üstündür.

Keywords

• Endometrial kanser
• Endoservikalküreaj
• LEEP

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