The Role of Hysteroscopy In Endometrial Cancer - Special Issue

Endometrial cancer (EC) is the most frequent gynecological malignancy. Hysteroscopy is a minimally invasive diagnostic and operative technique mainly deployed in cases presented with abnormal uterine bleeding (AUB) or infertility. During the last decades, diagnostic hysteroscopy tends to be at least equally important as the Dilatation & Curretage (D&C), in investigating AUB. By using this diagnostic method, the uterine cavity can be thoroughly visualized and an endometrial biopsy specimen can be taken under hysteroscopic view. An EC can be detected in 7-10% of postmenopausal patients and 2-3% of premenopausal patients submitted to hysteroscopy. Hysteroscopy has been recently confirmed to be an accurate diagnostic method in the diagnosis of endometrial carcinoma. Hysteroscopic examination before surgery in patients with endometrial cancer may increase the risk of dissemination of malignant cells into the peritoneal cavity. The risk was statistically significantly associated with the use of a liquid medium for uterine cavity distention but not with early-stage disease. There is no evidence to support an association between preoperative hysteroscopic examination and a worse prognosis. There is no reason to avoid diagnostic hysteroscopy before to surgery in patients with endometrial cancer, especially in early stages.