Utility of computerized tomography in clinical staging and surgical decision making in patients with uterine cancer
Objective: We investigated the utility of pre-operative computerized tomography (CT) abdomen and pelvis on clinical staging and surgical decision making for uterine carcinoma. Methods: This retrospective cohort study included patients treated surgically for uterine carcinoma between 2010 and 2021 at...
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Elsevier
2025-08-01
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| Series: | Gynecologic Oncology Reports |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2352578925001377 |
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| author | Andrew Tannous Alexzandra Adler Jeanelle Sheeder Rebecca J. Wolsky Jill Alldredge |
| author_facet | Andrew Tannous Alexzandra Adler Jeanelle Sheeder Rebecca J. Wolsky Jill Alldredge |
| author_sort | Andrew Tannous |
| collection | DOAJ |
| description | Objective: We investigated the utility of pre-operative computerized tomography (CT) abdomen and pelvis on clinical staging and surgical decision making for uterine carcinoma. Methods: This retrospective cohort study included patients treated surgically for uterine carcinoma between 2010 and 2021 at a single academic center. Data on patient demographics, tumor characteristics, CT imaging results, and surgical procedures were collected. Diagnostic accuracy metrics (sensitivity, specificity, positive predictive value [PPV], negative predictive value [NPV]) were analyzed to assess the predictive value of CT for determining extrauterine disease, lymphadenopathy, and omental involvement. The impact of CT imaging on surgical management decisions was also evaluated. Results: Of 409 patients meeting inclusion criteria, 68.9 % underwent pre-operative CT imaging. CT demonstrated moderate sensitivity (67.0 %, 61/91) and high specificity (87.4 %, 145/166) for detecting extrauterine disease, which was comparable across those with low grade endometrioid, high grade endometrioid, and non-endometrioid histotypes. Patients with abnormal CT findings were significantly more likely to have advanced stage disease (FIGO stage III/IV; p < 0.001), undergo tumor debulking (p < 0.001), and receive pelvic (p = 0.001) and para-aortic lymphadenectomy (p < 0.001). Conversely, patients with normal CT scans more frequently underwent minimally invasive surgery (MIS) and sentinel lymph node (SLN) procedures (p < 0.001). Conclusions: Preoperative CT shows moderate sensitivity but high specificity for identifying extrauterine disease in uterine carcinoma, supporting continued use for high risk histotypes. Among patients with low-grade histotypes, risk-adaptive use of CT may be valuable in determining eligibility for either MIS or SLN mapping. This is an increasingly relevant consideration as MIS and SLN are becoming more widely adopted. |
| format | Article |
| id | doaj-art-cffe71b5999e4377a802da6086d9615d |
| institution | Kabale University |
| issn | 2352-5789 |
| language | English |
| publishDate | 2025-08-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Gynecologic Oncology Reports |
| spelling | doaj-art-cffe71b5999e4377a802da6086d9615d2025-08-21T04:17:14ZengElsevierGynecologic Oncology Reports2352-57892025-08-016010181210.1016/j.gore.2025.101812Utility of computerized tomography in clinical staging and surgical decision making in patients with uterine cancerAndrew Tannous0Alexzandra Adler1Jeanelle Sheeder2Rebecca J. Wolsky3Jill Alldredge4Saint Joseph Hospital, Department of Obstetrics and Gynecology, Denver, CO, USA; Corresponding author at: 1960 Ogden Street, Suite 340, Denver, CO 80218, USA.University of Colorado School of Medicine, Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Aurora, CO, USAUniversity of Colorado School of Medicine, Department of Obstetrics and Gynecology, Division of Complex Family Planning, Aurora, CO, USAUniversity of Colorado School of Medicine, Department of Pathology, Aurora, CO, USAUniversity of Colorado School of Medicine, Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Aurora, CO, USAObjective: We investigated the utility of pre-operative computerized tomography (CT) abdomen and pelvis on clinical staging and surgical decision making for uterine carcinoma. Methods: This retrospective cohort study included patients treated surgically for uterine carcinoma between 2010 and 2021 at a single academic center. Data on patient demographics, tumor characteristics, CT imaging results, and surgical procedures were collected. Diagnostic accuracy metrics (sensitivity, specificity, positive predictive value [PPV], negative predictive value [NPV]) were analyzed to assess the predictive value of CT for determining extrauterine disease, lymphadenopathy, and omental involvement. The impact of CT imaging on surgical management decisions was also evaluated. Results: Of 409 patients meeting inclusion criteria, 68.9 % underwent pre-operative CT imaging. CT demonstrated moderate sensitivity (67.0 %, 61/91) and high specificity (87.4 %, 145/166) for detecting extrauterine disease, which was comparable across those with low grade endometrioid, high grade endometrioid, and non-endometrioid histotypes. Patients with abnormal CT findings were significantly more likely to have advanced stage disease (FIGO stage III/IV; p < 0.001), undergo tumor debulking (p < 0.001), and receive pelvic (p = 0.001) and para-aortic lymphadenectomy (p < 0.001). Conversely, patients with normal CT scans more frequently underwent minimally invasive surgery (MIS) and sentinel lymph node (SLN) procedures (p < 0.001). Conclusions: Preoperative CT shows moderate sensitivity but high specificity for identifying extrauterine disease in uterine carcinoma, supporting continued use for high risk histotypes. Among patients with low-grade histotypes, risk-adaptive use of CT may be valuable in determining eligibility for either MIS or SLN mapping. This is an increasingly relevant consideration as MIS and SLN are becoming more widely adopted.http://www.sciencedirect.com/science/article/pii/S2352578925001377Pre-operative CTUterine cancerPre-operative stagingMinimally invasive surgerySentinel lymph node |
| spellingShingle | Andrew Tannous Alexzandra Adler Jeanelle Sheeder Rebecca J. Wolsky Jill Alldredge Utility of computerized tomography in clinical staging and surgical decision making in patients with uterine cancer Gynecologic Oncology Reports Pre-operative CT Uterine cancer Pre-operative staging Minimally invasive surgery Sentinel lymph node |
| title | Utility of computerized tomography in clinical staging and surgical decision making in patients with uterine cancer |
| title_full | Utility of computerized tomography in clinical staging and surgical decision making in patients with uterine cancer |
| title_fullStr | Utility of computerized tomography in clinical staging and surgical decision making in patients with uterine cancer |
| title_full_unstemmed | Utility of computerized tomography in clinical staging and surgical decision making in patients with uterine cancer |
| title_short | Utility of computerized tomography in clinical staging and surgical decision making in patients with uterine cancer |
| title_sort | utility of computerized tomography in clinical staging and surgical decision making in patients with uterine cancer |
| topic | Pre-operative CT Uterine cancer Pre-operative staging Minimally invasive surgery Sentinel lymph node |
| url | http://www.sciencedirect.com/science/article/pii/S2352578925001377 |
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