Ultrasonographic evaluation of endometrial stripe thickness is insufficient to rule out uterine serous carcinoma
Purpose Uterine serous carcinoma (USC) is a rare endometrial cancer representing less than 10% of uterine cancers but contributing to up to 50% of the mortality. Delay in diagnosis with this high-grade histology can have significant clinical impact. USC is known to arise in a background of endometri...
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| Veröffentlicht in: | Cancer causes & control 2023-12, Vol.34 (12), p.1133-1138 |
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| creator | Kiff, Jaime M. Williams-Weisenberger, Mercedes Spellacy, Danielle Garg, Bharti Munro, Elizabeth G. Bruegl, Amanda S. |
| description | Purpose
Uterine serous carcinoma (USC) is a rare endometrial cancer representing less than 10% of uterine cancers but contributing to up to 50% of the mortality. Delay in diagnosis with this high-grade histology can have significant clinical impact. USC is known to arise in a background of endometrial atrophy. We investigated endometrial stripe (EMS) thickness in USC to evaluate current guidelines for postmenopausal bleeding in the context of this histology.
Methods
Retrospective chart review was conducted using ICD-9 and ICD-10 codes over an 18-year period. We included 139 patients with USC and compared characteristics of patients with EMS ≤ 4 mm and EMS > 4 mm. Chi-square or Fisher’s exact tests were used to compare proportions and two-tailed t-tests to compare means. A
p
-value of 4 mm. There were no statistically significant differences in age at diagnosis or presenting symptoms between groups, and postmenopausal bleeding was the most common symptom in each group.
Conclusion
Nearly 25% of patients with USC initially evaluated with transvaginal ultrasound were found to have an EMS ≤ 4 mm. If transvaginal ultrasound is used to triage these patients, one in four women will potentially experience a delay in diagnosis that may impact their prognosis. |
| doi_str_mv | 10.1007/s10552-023-01759-y |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2854428232</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2871973772</sourcerecordid><originalsourceid>FETCH-LOGICAL-c375t-601ef33bce6dfe74113a4f75631af23d520bbb1fadaa9fc7709391dc5d10822c3</originalsourceid><addsrcrecordid>eNp9kU1LHTEUhkOx1KvtH3BRAm66mfYkmdzcWRbphyB0U9chkznR2JlkzIdw_31jr7XgohA4izznPS88hJwx-MgA1KfMQEreARcdMCWHbv-KbJhUolOcyyOygUGqTvJeHJOTnO8AQG45vCHHQkmQgskNWa_nkkyOId4ks956S_HBzNUUHwONjmKY4oIleTPT3MaKtDTqV8CcqW8v5Oqctx5DoSXSVGeksRZaCyYfkGZMsWZqTbI-xMW8Ja-dmTO-e5qn5Prrl58X37urH98uLz5fdbaVK90WGDohRovbyaHqGROmd0puBTOOi0lyGMeROTMZMzirFAxiYJOVE4Md51ackg-H3DXF-4q56MVni_NsArZCmu9k3_MdF7yh5y_Qu1hTaO0apdighFKPFD9QNsWcEzq9Jr-YtNcM9KMPffChmw_9x4fet6X3T9F1XHB6XvkroAHiAOT2FW4w_bv9n9jf9-OY-A</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2871973772</pqid></control><display><type>article</type><title>Ultrasonographic evaluation of endometrial stripe thickness is insufficient to rule out uterine serous carcinoma</title><source>MEDLINE</source><source>SpringerNature Journals</source><creator>Kiff, Jaime M. ; Williams-Weisenberger, Mercedes ; Spellacy, Danielle ; Garg, Bharti ; Munro, Elizabeth G. ; Bruegl, Amanda S.</creator><creatorcontrib>Kiff, Jaime M. ; Williams-Weisenberger, Mercedes ; Spellacy, Danielle ; Garg, Bharti ; Munro, Elizabeth G. ; Bruegl, Amanda S.</creatorcontrib><description>Purpose
Uterine serous carcinoma (USC) is a rare endometrial cancer representing less than 10% of uterine cancers but contributing to up to 50% of the mortality. Delay in diagnosis with this high-grade histology can have significant clinical impact. USC is known to arise in a background of endometrial atrophy. We investigated endometrial stripe (EMS) thickness in USC to evaluate current guidelines for postmenopausal bleeding in the context of this histology.
Methods
Retrospective chart review was conducted using ICD-9 and ICD-10 codes over an 18-year period. We included 139 patients with USC and compared characteristics of patients with EMS ≤ 4 mm and EMS > 4 mm. Chi-square or Fisher’s exact tests were used to compare proportions and two-tailed t-tests to compare means. A
p
-value of < 0.05 was considered statistically significant.
Results
Most patients were white, obese, and multiparous. Thirty-two (23%) had an EMS ≤ 4 mm; 107 (77%) had an EMS > 4 mm. There were no statistically significant differences in age at diagnosis or presenting symptoms between groups, and postmenopausal bleeding was the most common symptom in each group.
Conclusion
Nearly 25% of patients with USC initially evaluated with transvaginal ultrasound were found to have an EMS ≤ 4 mm. If transvaginal ultrasound is used to triage these patients, one in four women will potentially experience a delay in diagnosis that may impact their prognosis.</description><identifier>ISSN: 0957-5243</identifier><identifier>EISSN: 1573-7225</identifier><identifier>DOI: 10.1007/s10552-023-01759-y</identifier><identifier>PMID: 37505315</identifier><language>eng</language><publisher>Cham: Springer International Publishing</publisher><subject>Atrophy ; Biomedical and Life Sciences ; Biomedicine ; Bleeding ; Cancer ; Cancer Research ; Carcinoma ; Cystadenocarcinoma, Serous - diagnostic imaging ; Diagnosis ; Endometrial cancer ; Endometrial Neoplasms - diagnostic imaging ; Endometrium ; Endometrium - pathology ; Epidemiology ; Female ; Hematology ; Histology ; Humans ; Medical diagnosis ; Oncology ; Original Paper ; Post-menopause ; Postmenopause ; Public Health ; Retrospective Studies ; Statistical analysis ; Thickness ; Ultrasonic imaging ; Ultrasound ; Uterine cancer ; Uterine Hemorrhage - diagnostic imaging ; Uterine Hemorrhage - etiology ; Uterine Hemorrhage - pathology ; Uterine Neoplasms - diagnostic imaging ; Uterus</subject><ispartof>Cancer causes & control, 2023-12, Vol.34 (12), p.1133-1138</ispartof><rights>The Author(s), under exclusive licence to Springer Nature Switzerland AG 2023. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.</rights><rights>2023. The Author(s), under exclusive licence to Springer Nature Switzerland AG.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c375t-601ef33bce6dfe74113a4f75631af23d520bbb1fadaa9fc7709391dc5d10822c3</citedby><cites>FETCH-LOGICAL-c375t-601ef33bce6dfe74113a4f75631af23d520bbb1fadaa9fc7709391dc5d10822c3</cites><orcidid>0000-0002-6731-0623 ; 0000-0002-3553-3013 ; 0000-0003-3307-4367</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s10552-023-01759-y$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s10552-023-01759-y$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>315,781,785,27929,27930,41493,42562,51324</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/37505315$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Kiff, Jaime M.</creatorcontrib><creatorcontrib>Williams-Weisenberger, Mercedes</creatorcontrib><creatorcontrib>Spellacy, Danielle</creatorcontrib><creatorcontrib>Garg, Bharti</creatorcontrib><creatorcontrib>Munro, Elizabeth G.</creatorcontrib><creatorcontrib>Bruegl, Amanda S.</creatorcontrib><title>Ultrasonographic evaluation of endometrial stripe thickness is insufficient to rule out uterine serous carcinoma</title><title>Cancer causes & control</title><addtitle>Cancer Causes Control</addtitle><addtitle>Cancer Causes Control</addtitle><description>Purpose
Uterine serous carcinoma (USC) is a rare endometrial cancer representing less than 10% of uterine cancers but contributing to up to 50% of the mortality. Delay in diagnosis with this high-grade histology can have significant clinical impact. USC is known to arise in a background of endometrial atrophy. We investigated endometrial stripe (EMS) thickness in USC to evaluate current guidelines for postmenopausal bleeding in the context of this histology.
Methods
Retrospective chart review was conducted using ICD-9 and ICD-10 codes over an 18-year period. We included 139 patients with USC and compared characteristics of patients with EMS ≤ 4 mm and EMS > 4 mm. Chi-square or Fisher’s exact tests were used to compare proportions and two-tailed t-tests to compare means. A
p
-value of < 0.05 was considered statistically significant.
Results
Most patients were white, obese, and multiparous. Thirty-two (23%) had an EMS ≤ 4 mm; 107 (77%) had an EMS > 4 mm. There were no statistically significant differences in age at diagnosis or presenting symptoms between groups, and postmenopausal bleeding was the most common symptom in each group.
Conclusion
Nearly 25% of patients with USC initially evaluated with transvaginal ultrasound were found to have an EMS ≤ 4 mm. If transvaginal ultrasound is used to triage these patients, one in four women will potentially experience a delay in diagnosis that may impact their prognosis.</description><subject>Atrophy</subject><subject>Biomedical and Life Sciences</subject><subject>Biomedicine</subject><subject>Bleeding</subject><subject>Cancer</subject><subject>Cancer Research</subject><subject>Carcinoma</subject><subject>Cystadenocarcinoma, Serous - diagnostic imaging</subject><subject>Diagnosis</subject><subject>Endometrial cancer</subject><subject>Endometrial Neoplasms - diagnostic imaging</subject><subject>Endometrium</subject><subject>Endometrium - pathology</subject><subject>Epidemiology</subject><subject>Female</subject><subject>Hematology</subject><subject>Histology</subject><subject>Humans</subject><subject>Medical diagnosis</subject><subject>Oncology</subject><subject>Original Paper</subject><subject>Post-menopause</subject><subject>Postmenopause</subject><subject>Public Health</subject><subject>Retrospective Studies</subject><subject>Statistical analysis</subject><subject>Thickness</subject><subject>Ultrasonic imaging</subject><subject>Ultrasound</subject><subject>Uterine cancer</subject><subject>Uterine Hemorrhage - diagnostic imaging</subject><subject>Uterine Hemorrhage - etiology</subject><subject>Uterine Hemorrhage - pathology</subject><subject>Uterine Neoplasms - diagnostic imaging</subject><subject>Uterus</subject><issn>0957-5243</issn><issn>1573-7225</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNp9kU1LHTEUhkOx1KvtH3BRAm66mfYkmdzcWRbphyB0U9chkznR2JlkzIdw_31jr7XgohA4izznPS88hJwx-MgA1KfMQEreARcdMCWHbv-KbJhUolOcyyOygUGqTvJeHJOTnO8AQG45vCHHQkmQgskNWa_nkkyOId4ks956S_HBzNUUHwONjmKY4oIleTPT3MaKtDTqV8CcqW8v5Oqctx5DoSXSVGeksRZaCyYfkGZMsWZqTbI-xMW8Ja-dmTO-e5qn5Prrl58X37urH98uLz5fdbaVK90WGDohRovbyaHqGROmd0puBTOOi0lyGMeROTMZMzirFAxiYJOVE4Md51ackg-H3DXF-4q56MVni_NsArZCmu9k3_MdF7yh5y_Qu1hTaO0apdighFKPFD9QNsWcEzq9Jr-YtNcM9KMPffChmw_9x4fet6X3T9F1XHB6XvkroAHiAOT2FW4w_bv9n9jf9-OY-A</recordid><startdate>20231201</startdate><enddate>20231201</enddate><creator>Kiff, Jaime M.</creator><creator>Williams-Weisenberger, Mercedes</creator><creator>Spellacy, Danielle</creator><creator>Garg, Bharti</creator><creator>Munro, Elizabeth G.</creator><creator>Bruegl, Amanda S.</creator><general>Springer International Publishing</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7TO</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>H94</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-6731-0623</orcidid><orcidid>https://orcid.org/0000-0002-3553-3013</orcidid><orcidid>https://orcid.org/0000-0003-3307-4367</orcidid></search><sort><creationdate>20231201</creationdate><title>Ultrasonographic evaluation of endometrial stripe thickness is insufficient to rule out uterine serous carcinoma</title><author>Kiff, Jaime M. ; Williams-Weisenberger, Mercedes ; Spellacy, Danielle ; Garg, Bharti ; Munro, Elizabeth G. ; Bruegl, Amanda S.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c375t-601ef33bce6dfe74113a4f75631af23d520bbb1fadaa9fc7709391dc5d10822c3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Atrophy</topic><topic>Biomedical and Life Sciences</topic><topic>Biomedicine</topic><topic>Bleeding</topic><topic>Cancer</topic><topic>Cancer Research</topic><topic>Carcinoma</topic><topic>Cystadenocarcinoma, Serous - diagnostic imaging</topic><topic>Diagnosis</topic><topic>Endometrial cancer</topic><topic>Endometrial Neoplasms - diagnostic imaging</topic><topic>Endometrium</topic><topic>Endometrium - pathology</topic><topic>Epidemiology</topic><topic>Female</topic><topic>Hematology</topic><topic>Histology</topic><topic>Humans</topic><topic>Medical diagnosis</topic><topic>Oncology</topic><topic>Original Paper</topic><topic>Post-menopause</topic><topic>Postmenopause</topic><topic>Public Health</topic><topic>Retrospective Studies</topic><topic>Statistical analysis</topic><topic>Thickness</topic><topic>Ultrasonic imaging</topic><topic>Ultrasound</topic><topic>Uterine cancer</topic><topic>Uterine Hemorrhage - diagnostic imaging</topic><topic>Uterine Hemorrhage - etiology</topic><topic>Uterine Hemorrhage - pathology</topic><topic>Uterine Neoplasms - diagnostic imaging</topic><topic>Uterus</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Kiff, Jaime M.</creatorcontrib><creatorcontrib>Williams-Weisenberger, Mercedes</creatorcontrib><creatorcontrib>Spellacy, Danielle</creatorcontrib><creatorcontrib>Garg, Bharti</creatorcontrib><creatorcontrib>Munro, Elizabeth G.</creatorcontrib><creatorcontrib>Bruegl, Amanda S.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Oncogenes and Growth Factors Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>MEDLINE - Academic</collection><jtitle>Cancer causes & control</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Kiff, Jaime M.</au><au>Williams-Weisenberger, Mercedes</au><au>Spellacy, Danielle</au><au>Garg, Bharti</au><au>Munro, Elizabeth G.</au><au>Bruegl, Amanda S.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Ultrasonographic evaluation of endometrial stripe thickness is insufficient to rule out uterine serous carcinoma</atitle><jtitle>Cancer causes & control</jtitle><stitle>Cancer Causes Control</stitle><addtitle>Cancer Causes Control</addtitle><date>2023-12-01</date><risdate>2023</risdate><volume>34</volume><issue>12</issue><spage>1133</spage><epage>1138</epage><pages>1133-1138</pages><issn>0957-5243</issn><eissn>1573-7225</eissn><abstract>Purpose
Uterine serous carcinoma (USC) is a rare endometrial cancer representing less than 10% of uterine cancers but contributing to up to 50% of the mortality. Delay in diagnosis with this high-grade histology can have significant clinical impact. USC is known to arise in a background of endometrial atrophy. We investigated endometrial stripe (EMS) thickness in USC to evaluate current guidelines for postmenopausal bleeding in the context of this histology.
Methods
Retrospective chart review was conducted using ICD-9 and ICD-10 codes over an 18-year period. We included 139 patients with USC and compared characteristics of patients with EMS ≤ 4 mm and EMS > 4 mm. Chi-square or Fisher’s exact tests were used to compare proportions and two-tailed t-tests to compare means. A
p
-value of < 0.05 was considered statistically significant.
Results
Most patients were white, obese, and multiparous. Thirty-two (23%) had an EMS ≤ 4 mm; 107 (77%) had an EMS > 4 mm. There were no statistically significant differences in age at diagnosis or presenting symptoms between groups, and postmenopausal bleeding was the most common symptom in each group.
Conclusion
Nearly 25% of patients with USC initially evaluated with transvaginal ultrasound were found to have an EMS ≤ 4 mm. If transvaginal ultrasound is used to triage these patients, one in four women will potentially experience a delay in diagnosis that may impact their prognosis.</abstract><cop>Cham</cop><pub>Springer International Publishing</pub><pmid>37505315</pmid><doi>10.1007/s10552-023-01759-y</doi><tpages>6</tpages><orcidid>https://orcid.org/0000-0002-6731-0623</orcidid><orcidid>https://orcid.org/0000-0002-3553-3013</orcidid><orcidid>https://orcid.org/0000-0003-3307-4367</orcidid></addata></record> |
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| ispartof | Cancer causes & control, 2023-12, Vol.34 (12), p.1133-1138 |
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| subjects | Atrophy Biomedical and Life Sciences Biomedicine Bleeding Cancer Cancer Research Carcinoma Cystadenocarcinoma, Serous - diagnostic imaging Diagnosis Endometrial cancer Endometrial Neoplasms - diagnostic imaging Endometrium Endometrium - pathology Epidemiology Female Hematology Histology Humans Medical diagnosis Oncology Original Paper Post-menopause Postmenopause Public Health Retrospective Studies Statistical analysis Thickness Ultrasonic imaging Ultrasound Uterine cancer Uterine Hemorrhage - diagnostic imaging Uterine Hemorrhage - etiology Uterine Hemorrhage - pathology Uterine Neoplasms - diagnostic imaging Uterus |
| title | Ultrasonographic evaluation of endometrial stripe thickness is insufficient to rule out uterine serous carcinoma |
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