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Obstetrics and Gynecology International
Volume 2012, Article ID 414086, 6 pages
Research Article

Interobserver Agreement for Endometrial Cancer Characteristics Evaluated on Biopsy Material

1Department of Pathology, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada M4N 3M5
2Division of Radiation Oncology, Odette Cancer Centre, Toronto, ON, Canada M4N 3M5

Received 13 May 2011; Accepted 17 October 2011

Academic Editor: Sean Blackwell

Copyright © 2012 S. Nofech-Mozes et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


A shift toward a disease-based therapy designed according to patterns of failure and likelihood of nodal involvement predicted by pathologic determinants has recently led to considering a selective approach to lymphadenectomy for endometrial cancer. Therefore, it became critical to examine reproducibility of diagnosing the key determinants of risk, on preoperative endometrial tissue samples as well as the concordance between preoperative and postresection specimens. Six gynaecologic pathologists assessed 105 consecutive endometrial biopsies originally reported as positive for endometrial cancer for cell type (endometrioid versus nonendometrioid), tumor grade (FIGO 3-tiered and 2-tiered), nuclear grade, and risk category (low risk defined as endometrioid histology, grade 1 + 2 and nuclear grade <3). Interrater agreement levels were substantial for identification of nonendometrioid histology ( = 0.63; SE = 0.025), high tumor grade ( = 0.64; SE = 0.025), and risk category ( = 0.66; SE = 0.025). The overall agreement was fair for nuclear grade ( = 0.21; SE = 0.025). There is agreement amongst pathologists in identifying high-risk pathologic determinants on endometrial cancer biopsies, and these highly correlate with postresection specimens. This is ascertainment prerequisite adaptation of the paradigm shift in surgical staging of patients with endometrial cancer.