What is the proper work-up of the patient with clinical early stage uterine adenocarcinoma?.

Patsner, Bruce; Anderson, Matthew L

doi:2012.55.7.447

Obstet Gynecol Sci > Volume 55(7); 2012 > Article

Review

Korean Journal of Obstetrics & Gynecology 2012;55(7):447-453.
DOI: https://doi.org/10.5468/KJOG.2012.55.7.447 Published online July 13, 2012.

What is the proper work-up of the patient with clinical early stage uterine adenocarcinoma?.

Bruce Patsner, Matthew L Anderson

¹Department of Obstetrics and Gynecology, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea. bpatsner@yonsei.ac.kr
²Division of Gynecologic Oncology, Department Obstetrics and Gynecology, Clinical and Translational Research, Baylor College of Medicine, Houston, TX, USA.

Abstract

OBJECTIVE
To discuss the proper preoperative workup of patients with uterine adenocarcinoma who present with disease clinically confined to the uterine corpus. METHODS: Review of recommendations suggested in major textbooks in gynecologic oncology over the past thirty five years as well as select recent publications in the gynecologic oncology literature in Asia as well as the United States and Europe. RESULTS: The suggested preoperative testing for the patient population under consideration has evolved over the years depending on whether the patient is at low risk or high risk for occult metastatic disease. CONCLUSION: Standard preoperative testing is always indicated but preoperative CA-125 and advanced radiological imaging are never routinely indicated for "low risk" patients. Either test may be indicated in select high-risk patients in the setting of clinical investigation though it is unclear which test, if either, provides enough meaningful clinical information which will either alter surgical management or which may be justified in light of the predicted high percentage of patients who will have normal preoperative test results.

Key Words: Uterine adenocarcinoma, Preoperative evaluation, CA-125