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Hefler-Frischmuth, K; Hirtl-Goergl, E; Unterrichter, V; Lafleur, J; Brunnmayr-Petkin, G; Moinfar, F; Hefler, L.
One-stop clinical assessment of risk for endometrial hyperplasia (OSCAR-Endo): a fast-track protocol for evaluating endometrial pathologies.
Arch Gynecol Obstet. 2017; 295(4):959-964
Doi: 10.1007/s00404-017-4326-8
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- Co-authors Med Uni Graz
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Moinfar Farid
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- Abstract:
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To evaluate a one-stop clinical assessment of risk for assessing endometrial pathologies (OSCAR-Endo), consisting of a fast-track protocol with hysteroscopy, dilation and curettage (D&C) with intraoperative frozen section analysis of the removed tissue in cases of hysteroscopic suspicion of malignancy.
In this prospective clinical trial, a total of 304 consecutive women with sonographically suspected endometrial hyperplasia and/or postmenopausal bleeding, underwent D&C with intraoperative frozen section analysis between May 2013 and September 2015. Based on the results of the hysteroscopy and/or frozen section, the OSCAR-Endo score was reported: negative, when no frozen section was regarded necessary or the frozen section yielded a negative result; equivocal, when the frozen section reported an equivocal result; positive, when frozen section reported either complex hyperplasia with atypia or cancer.
Frozen sections were required by the surgeons in 59 (19.4%) of cases. When compared with the final histology after D&C, frozen section showed a sensitivity, specificity, PPV, NPV, and overall test accuracy of 91.3, 100, 100, 94.1, and 96.3% for predicting malignant disease, respectively. The OSCAR-Endo score showed a sensitivity, specificity, PPV, NPV, and overall test accuracy of 84, 100, 100, 98.6, and 98.7% for predicting malignant disease, respectively.
The OSCAR-Endo protocol is easy to perform in daily clinical practice reaching an excellent test accuracy. It helps in immediate postoperative counseling of affected patients. Clinical Trial Registration http://www.clinicaltrials.gov ; NCT01961102.
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Adult -
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Aged -
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Dilatation and Curettage -
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Endometrial Hyperplasia - diagnostic imaging
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Endometrial Hyperplasia - pathology
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Endometrial Hyperplasia - surgery
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Endometrial Neoplasms - pathology
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Endometrial Neoplasms - surgery
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Female -
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Frozen Sections -
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Humans -
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Hysteroscopy -
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Middle Aged -
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Prospective Studies -
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Risk Assessment -
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Sensitivity and Specificity -
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Ultrasonography -
- Find related publications in this database (Keywords)
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Hysteroscopy
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Frozen section
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Endometrial cancer
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Endometrial pathology
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DANDC