{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T11:23:53Z","timestamp":1785842633410,"version":"3.56.0"},"reference-count":29,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2021,6,9]],"date-time":"2021-06-09T00:00:00Z","timestamp":1623196800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100002794","name":"Cancerfonden","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100002794","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Obstet Gynecol Scand"],"published-print":{"date-parts":[[2021,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Deep myometrial invasion (\u226550%) is a prognostic factor for lymph node metastases and decreased survival in endometrial cancer. There is no consensus regarding which pre\/intraoperative diagnostic method should be preferred. Our aim was to explore the pattern of diagnostic methods for myometrial invasion assessment in Sweden and to evaluate differences among magnetic resonance imaging (MRI), transvaginal sonography, frozen section, and gross examination in clinical practice.<\/jats:p><\/jats:sec><jats:sec><jats:title>Material and methods<\/jats:title><jats:p>This is a nationwide historical cohort study; women with endometrial cancer with data on assessment of myometrial invasion and FIGO stage I\u2010III registered in the Swedish Quality Registry for Gynecologic Cancer <jats:bold>(<\/jats:bold>SQRGC) between 2017 and 2019 were eligible. Data on age, histology, FIGO stage, method, and results of myometrial invasion assessment, pathology results, and hospital level were collected from the SQRGC. The final assessment by the pathologist was considered the reference standard.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In the study population of 1401 women, 32% (n\u00a0=\u00a0448) had myometrial invasion of 50% of more. The methods reported for myometrial invasion assessment were transvaginal sonography in 59%, MRI in 28%, gross examination in 8% and frozen section in 5% of cases. Only minor differences were found for age and FIGO stage when comparing methods applied for myometrial invasion assessment. The sensitivity, specificity, and accuracy to find myometrial invasion of 50% or more with transvaginal sonography were 65.6%, 80.3%, and 75.8%, for MRI they were 76.9%, 71.9%, and 73.8%, for gross examination they were 71.9%, 93.6%, and 87.3%, and for frozen section they were 90.0%, 92.7%, and 92.0%, respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In Sweden, the assessment of deep myometrial invasion is most often performed with transvaginal sonography, but the sensitivity is lower than for the other diagnostic methods. In clinical practice, the accuracy is moderate for transvaginal sonography and MRI.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aogs.14146","type":"journal-article","created":{"date-parts":[[2021,3,15]],"date-time":"2021-03-15T16:44:02Z","timestamp":1615826642000},"page":"1526-1533","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":30,"title":["Preoperative and intraoperative assessment of myometrial invasion in endometrial cancer\u2014A Swedish Gynecologic Cancer Group (SweGCG) study"],"prefix":"10.1111","volume":"100","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8962-4351","authenticated-orcid":false,"given":"Bj\u00f6rg","family":"J\u00f3nsd\u00f3ttir","sequence":"first","affiliation":[{"name":"Department of Women's and Children's Health Uppsala University Uppsala Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Janusz","family":"Marcickiewicz","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Varbergs Hospital Region Halland Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christer","family":"Borgfeldt","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Sk\u00e5ne University Hospital, and Department of Clinical Sciences Lund University Lund Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Bjurberg","sequence":"additional","affiliation":[{"name":"Department of Hematology, Oncology, and Radiation Physics Sk\u00e5ne University Hospital Lund University Lund Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6699-893X","authenticated-orcid":false,"given":"Pernilla","family":"Dahm\u2010K\u00e4hler","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Sahlgrenska University Hospital Sahlgrenska Academy at University of Gothenburg Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angelique","family":"Fl\u00f6ter\u2010R\u00e5destad","sequence":"additional","affiliation":[{"name":"Department of Women's and Children's Health Division of Obstetrics and Gynecology Karolinska Institutet. Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristina","family":"Hellman","sequence":"additional","affiliation":[{"name":"Department of Gynecologic Cancer Theme Cancer Karolinska University Hospital Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erik","family":"Holmberg","sequence":"additional","affiliation":[{"name":"Regional Cancer Center Western Sweden Gothenburg Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5702-4116","authenticated-orcid":false,"given":"Preben","family":"Kj\u00f8lhede","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology and Department of Biomedical and Clinical Sciences Link\u00f6ping University Link\u00f6ping Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Per","family":"Rosenberg","sequence":"additional","affiliation":[{"name":"Department of Oncology and Department of Biomedical and Clinical Sciences Link\u00f6ping University Link\u00f6ping Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bengt","family":"Tholander","sequence":"additional","affiliation":[{"name":"Department of Oncology Uppsala University Hospital Uppsala Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elisabeth","family":"\u00c5vall\u2010Lundqvist","sequence":"additional","affiliation":[{"name":"Department of Oncology and Department of Biomedical and Clinical Sciences Link\u00f6ping University Link\u00f6ping Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5527-8796","authenticated-orcid":false,"given":"Karin","family":"St\u00e5lberg","sequence":"additional","affiliation":[{"name":"Department of Women's and Children's Health Uppsala University Uppsala Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"H\u00f6gberg","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology Institute of Clinical Sciences Lund University Lund Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,6,9]]},"reference":[{"key":"e_1_2_9_2_1","unstructured":"NORDCAN AotNCR.Cancer stat fact sheet.http:\/\/www\u2010dep.iarc.fr\/NORDCAN\/SW\/StatsFact.asp?cancer=222&country=752.2020."},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.radonc.2015.11.013"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0020-7292(06)60031-3"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.5402\/2012\/325790"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.30707"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1080\/0284186X.2019.1643036"},{"key":"e_1_2_9_8_1","first-page":"CD007585","article-title":"Lymphadenectomy for the management of endometrial cancer","volume":"10","author":"Frost JA","year":"2017","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2005.04.144"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ygyno.2012.11.025"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.5295"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.14740\/jcgo537"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ygyno.2012.08.024"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0412.2012.01406.x"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1097\/IGC.0000000000000618"},{"key":"e_1_2_9_16_1","unstructured":"Cancer SNGfE.Swedish National Guidelines for Endometrial Cancer.https:\/\/kunskapsbanken.cancercentrum.se\/diagnoser\/livmoderkroppscancer\/vardprogram\/."},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1080\/02841860802247664"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10654-017-0316-1"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1080\/0284186X.2017.1366048"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.14905"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.14645"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ygyno.2018.06.027"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1469-0705.1992.02010035.x"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.2503080877"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.1155\/2017\/1318203"},{"key":"e_1_2_9_26_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0412.2011.01166.x"},{"key":"e_1_2_9_27_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00404-019-05158-0"},{"key":"e_1_2_9_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejogrb.2012.07.005"},{"key":"e_1_2_9_29_1","doi-asserted-by":"publisher","DOI":"10.1111\/aogs.12048"},{"key":"e_1_2_9_30_1","doi-asserted-by":"publisher","DOI":"10.1136\/ijgc-2018-000020"}],"container-title":["Acta Obstetricia et Gynecologica Scandinavica"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/aogs.14146","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/aogs.14146","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/aogs.14146","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,29]],"date-time":"2023-08-29T20:37:59Z","timestamp":1693341479000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1111\/aogs.14146"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,6,9]]},"references-count":29,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2021,8]]}},"alternative-id":["10.1111\/aogs.14146"],"URL":"https:\/\/doi.org\/10.1111\/aogs.14146","archive":["Portico"],"relation":{},"ISSN":["0001-6349","1600-0412"],"issn-type":[{"value":"0001-6349","type":"print"},{"value":"1600-0412","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,6,9]]},"assertion":[{"value":"2020-11-13","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-03-11","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-06-09","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}