Computed tomography of primary, persistent, and recurrent endometrial malignancy

For 45 months, 24 patients with primary endometrial malignancy, 12 patients with suspected persistent tumor, and 29 patients with suspected recurrent tumor were evaluated with computed tomography (CT). In staging primary tumors, CT could not differentiate stage IA, IB, and II lesions and showed extrauterine tumor in only one (7%) of 15 clinical stage I--II tumours. CT was valuable in clinical stage III tumors by showing both parametrial extension and extrapelvic metastases. CT-surgical stage comparison showed an 83% accuracy in showing tumor confined to the uterus and an 86% accuracy in showing extrauterine tumor spread. CT did not detect microscopic pelvic node metastases or microscopic bladder involvement. In persistent and recurrent tumors, CT was sensitive in detecting both pelvic tumor and lymphatic, peritoneal, and mesenteric metastases. These data were supplemental to clinical assessment in choosing among surgical, radiation, or chemotherapy treatment. Vaginal recurrences were best evaluated by clinical examination and cytology.
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