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