2022-RA-1650-ESGO Sonographic assessment of features suspicious of uterine sarcoma: evaluation of their use in preoperative prediction of malignancy

Introduction/Background The recognition of uterine sarcoma allows correct therapy planning and choice surgical approach. To help to distinguish benign myoma from sarcoma, we assessed the value 6 sonographic criteria (Sarcoma Prediction Score – SPS) in a prospective cohort consecutive patients with masses. Methodology Patients planned for surgery between 2015–2019 presumed myometrial masses were prospectively evaluated standardized ultrasound examination. For triage, following investigated: rapid growth i(3 months), high blood flow, atypical (postmenopause), irregular lining, central necrosis, oval solitary lesion. evaluation was binary, score could range 0 6. Gold standard histological diagnosis. Results 522 myomas, 14 sarcomas, 2 gastrointestinal stromal tumors connection uterus, 7 other malignancies included. In group malignant tumors, 75.0% postmenopausal 25.0% premenopausal, while group, 76.8% premenopausal. median SPS mesenchymal 2.5 (range: 0–4, mean 2.6) vs myomas 0–3, 0.17). most common leading false positive flow. detection sarcoma/mesenchymal at threshold >1, sensitivity 93.75%, specificity 97.9%, PPV NPV 57.7% 99.8%, respectively. AUC 0.95. Conclusion use probability histology if is negative. A higher risk malignancy given when ≥ 1 are present women. premenopausal women, flow may lead scores; increases accuracy. We suggest triage suspected lesions.