Prevalence of sonographic signs in women with uterine sarcoma: a systematic review and meta-analysis

Abstract

Objective To assess the prevalence of sonographic signs in women with uterine sarcoma.

Materials and Methods A systematic review and meta-analysis were performed. Five electronic databases were searched from inception to June 2022 for all studies allowing calculation of the prevalence of sonographic signs in women with uterine sarcoma. Pooled prevalence with 95% confidence intervals was calculated for each sonographic sign and was a priori defined as “very high” when it was ≥ 80%, “high” when it ranged from 80% to 70%, and less relevant when it was ≤ 70%.

Results 6 studies with 317 sarcoma patients were included. The pooled prevalence was:

• 25.0% (95%CI:15.4–37.9%) for absence of visibility of the myometrium

• 80.5% (95%CI:74.8–85.2%) for solid component

• 78.3% (95%CI:59.3–89.9%) for inhomogeneous echogenicity of solid component

• 47.9% (95%CI:41.1–54.8%) for cystic areas

• 80.7% (95%CI:68.3–89.0%) for irregular walls of cystic areas

• 72.3% (95%CI:16.7–97.2%) for anechoic cystic areas

• 54.8% (95%CI:34.0–74.1%) for absence of shadowing

• 73.5% (95%CI:43.3–90.9%) for absence of calcifications

• 48.7% (95%CI:18.6–79.8%) for color score 3 or 4

• 47.3% (95%CI:37.0–57.8%) for irregular tumor borders

• 45.4% (95%CI:27.6–64.3%) for endometrial cavity not visualizable

• 10.9% (95%CI:3.5–29.1%) for free pelvic fluid

• 6.4% (95%CI:1.1–30.2%) for ascites

• 21.2% (95%CI:2.1–76.8%) for intracavitary process

• 81.5% (95%CI:56.1–93.8%) for singular lesion.

Conclusion Solid component, irregular walls of cystic areas, and singular lesions are signs with very high prevalence, while inhomogeneous echogenicity of solid component, anechoic cystic areas, and absence of calcifications are signs with high prevalence. The remaining signs were less relevant.

Zusammenfassung

Ziel Bewertung der Prävalenz sonografischer Zeichen bei Frauen mit Uterussarkom.

Material und Methoden Es wurden eine systematische Überprüfung und eine Meta-Analyse durchgeführt. Fünf elektronische Datenbanken wurden von Anfang bis Juni 2022 nach allen Studien durchsucht, die eine Berechnung der Prävalenz sonografischer Zeichen bei Frauen mit Uterussarkom ermöglichten. Die gepoolte Prävalenz mit 95%-Konfidenzintervallen wurde für jedes sonografische Zeichen berechnet und a priori als „sehr hoch“ definiert, wenn sie ≥ 80% war, „hoch“, wenn sie zwischen 80% und 70% lag, und als weniger relevant, wenn sie ≤70% lag.

Ergebnisse Es wurden 6 Studien mit 317 Sarkom-Patientinnen eingeschlossen. Die gepoolte Prävalenz betrug:

• 25,0% (95%-CI: 15,4–37,9%) bei fehlender Sichtbarkeit des Myometriums

• 80,5% (95%-CI: 74,8–85,2%) für eine solide Komponente

• 78,3% (95%-CI: 59,3–89,9%) für inhomogene Echogenität der soliden Komponente

• 47,9% (95%-CI: 41,1–54,8%) für zystische Bereiche

• 80,7% (95%-CI: 68,3–89,0%) für unregelmäßige Wände der zystischen Bereiche

• 72,3% (95%-CI: 16,7–97,2%) für echofreie zystische Bereiche

• 54,8% (95%-CI: 34,0–74,1%) für das Fehlen von Schattenbildung für keine Abschattung

• 73,5% (95%-CI: 43,3–90,9%) für das Fehlen von Verkalkungen

• 48,7% (95%-CI: 18,6–79,8%) für den Farbscore 3 oder 4

• 47,3% (95%-CI: 37,0–57,8%) für unregelmäßige Tumorgrenzen

• 45,4% (95%-CI: 27,6–64,3%) für eine nicht sichtbare Gebärmutterhöhle

• 10,9% (95%-CI: 3,5–29,1%) für freie Beckenflüssigkeit

• 6,4% (95%-CI: 1,1–30,2%) für Aszites

• 21,2% (95%-CI: 2,1–76,8%) für einen intrakavitären Prozess

• 81,5% (95%-CI: 56,1–93,8 %) für singuläre Läsionen.

Schlussfolgerung Zeichen mit sehr hoher Prävalenz sind eine solide Komponente, unregelmäßige Wände der zystischen Bereiche und singuläre Läsionen, während Zeichen mit hoher Prävalenz eine inhomogene Echogenität der soliden Komponente, echofreie zystische Bereiche und das Fehlen von Verkalkungen sind. Die übrigen Zeichen waren weniger relevant.

Keywords

malignancy - myomata - leiomyosarcoma - prediction - preoperative assessment

Publication History

Received: 24 March 2023

Accepted: 10 August 2023

Accepted Manuscript online:
10 August 2023

Article published online:
28 September 2023

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