The aim of this study was to assess the accuracy of a preoperative screening algorithm in identifying low-risk endometrial cancer (EC) patients to ensure optimal care. A total of 277 patients with primary EC confirmed through biopsy underwent magnetic resonance imaging (MRI). Patients with risk factors for advanced high-risk EC, such as non-endometrioid histology, high-grade differentiation status, deep myometrial invasion, or spread beyond the uterine corpus, were systematically excluded. The remaining preoperatively screened patients with stage IA low-grade endometrioid EC (EEC) (n = 93) underwent surgery in a tertiary hospital. The accuracy of the preoperative diagnosis was evaluated by comparing the findings with the postoperative histopathological results. Disease-free survival (DFS) and overall survival (OS) were analyzed using 8-year follow-up data. Postoperative histopathological analysis revealed that all patients had grade 1–2 EEC localized to the corpus uteri. Only three patients had deep myometrial invasion (stage IB), but they remained disease-free after 6–9 years of follow-up. The median follow-up time for all patients was 8.7 years. The DFS was 7.6 years, and the OS was 8.6 years. Two patients with stage IA grade 1 EEC experienced relapse and, despite treatment, died of EC. No other EC-related deaths occurred. The screening algorithm accurately identified low-risk EC patients without compromising survival. Therefore, the algorithm appears to be feasible for selecting patients for surgery in secondary hospitals.

中文翻译：

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二级医院对选定的低风险子宫内膜癌患者进行手术安全吗？

本研究的目的是评估术前筛查算法在识别低风险子宫内膜癌 (EC) 患者方面的准确性，以确保最佳护理。共有 277 名经活检确诊为原发性 EC 的患者接受了磁共振成像 (MRI)。系统排除具有晚期高危 EC 危险因素的患者，例如非子宫内膜样组织学、高分化状态、深部肌层浸润或扩散到子宫体以外。其余术前筛查的 IA 期低级别子宫内膜样 EC (EEC) 患者 (n = 93) 在三级医院接受了手术。通过将结果与术后组织病理学结果进行比较来评估术前诊断的准确性。使用 8 年随访数据分析无病生存期 (DFS) 和总生存期 (OS)。术后组织病理学分析显示，所有患者均存在局限于子宫体的 1-2 级 EEC。只有 3 名患者出现深肌层浸润（IB 期），但在 6-9 年的随访后，他们仍然无病。所有患者的中位随访时间为 8.7 年。 DFS 为 7.6 年，OS 为 8.6 年。两名 IA 期 1 级 EEC 患者出现复发，尽管接受了治疗，还是死于 EC。没有发生其他与 EC 相关的死亡。筛查算法准确地识别出低风险 EC 患者，且不影响生存。因此，该算法对于选择二级医院进行手术的患者似乎是可行的。