Re-staging surgery in endometrial cancer: an audit on its value


  • Sanjay Badesara Department of Surgical Oncology, Delhi State Cancer Institute, Delhi, India
  • Ashitha R. Gangadharan Department of Surgical Oncology, Malabar Cancer Centre, Kerala, India
  • Rambeer Singh Department of General Surgery, PGIMS, Rohtak, Haryana, India
  • Adarsh Dharmarajan Department of Surgical Oncology, Malabar Cancer Centre, Kerala, India



Endometrial carcinoma, Upstaging, Restaging surgery, Completion surgery


Background: Incomplete surgical staging in carcinoma endometrium is not an uncommon entity in developing world. Proper surgical staging has got a role in prognostication and planning adjuvant treatment. So, an audit was done to assess the extent of upstaging in women with endometrial cancers who were referred to index centre from outside hospitals with incomplete surgical staging.

Methods: It is a retrospective study. The demographic, clinical and treatment details of women with complete data having at-least one follow up after completion surgery were analyzed. Patients who had any other anticancer treatment elsewhere were excluded. The extent of upstaging was studied based on International federation of gynecology and obstetrics (FIGO) 2008 staging.

Results: A total of 88 patients of endometrial cancer were evaluated retrospectively, of which 10 had completion surgery. 10% of the patients were upstaged according to the FIGO stage (one from IA to IB), while one patient upstaged from IIIA to IVB after slide review by index centre. According to FIGO Grade, 40% patient upgraded (one upgraded from I to II, three from II to III) while one downgraded from II to I. Recurrence rate was 40%.

Conclusions: Upstaging is seen in 10% of patient after completion surgery, which requires the necessity of evaluation by gynecologic oncologist selectively. However, larger and multi-centric studies needed to draw definite conclusion. There is a significant discordance in grade and histology after the review at index centre.


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