TY - JOUR
T1 - Surgical and systemic management of endometrial cancer
T2 - an international survey
AU - Fotopoulou, Christina
AU - Kraetschell, Robert
AU - Dowdy, Sean
AU - Fujiwara, Keiichi
AU - Yaegashi, Nobuo
AU - Larusso, Domenica
AU - Casado, Antonio
AU - Mahner, Sven
AU - Herzog, Thomas J.
AU - Kehoe, Sean
AU - Vergote, Ignace
AU - Miller, David Scott
AU - Marth, Christian
AU - Fujii, Shingo
AU - Sehouli, Jalid
N1 - Publisher Copyright:
© 2014, Springer-Verlag Berlin Heidelberg.
PY - 2015/4
Y1 - 2015/4
N2 - Purpose: To ascertain the spectrum of clinical management of endometrial carcinoma (EC) the largest international survey was conducted to evaluate and identify differences worldwide. Methods: After validation of a 15-item questionnaire regarding surgical and adjuvant treatment of EC in Germany, an English-adapted questionnaire was put online and posted to all the major gynecological cancer Societies worldwide for further distribution commencing in 2010 and continued for 26 months. Results: A total of 618 Institutions around the world participated: Central Europe (CE), Southern Europe (SE), Northern Europe (NE), Asia and USA/Canada/UK. Both a therapeutic and staging value was attributed to systematic pelvic and paraaortic lymph node dissection (LND) in CE (74.6 %) and in Asia (67.2 %), as opposed to USA/UK where LND was mainly for staging purposes (53.5 %; p < 0.001). LND was performed up to the renal veins in CE in 86.8 %, in Asia in 80.8 %, in USA/UK in 51.2 % and in SE in 45.1 % (p < 0.001) of cases. In advanced disease, centers from Asia were treated most with adjuvant chemotherapy alone (93.6 %), as opposed to centers in SE, CE and UK/USA that employed combination chemo-radiotherapy in 90.9 % (p < 0.001) of cases. Paclitaxel/carboplatin was mostly used followed by doxorubicin/cisplatin (75 vs. 23.3 %; p < 0.001). In total, 94 % of all participants supported the concept of treating EC patients within appropriate clinical trials. Conclusions: There is broad range in both the surgical and adjuvant treatment of EC across different countries. Large-scale multicenter prospective trials are warranted to establish consistent, evidence-based guidelines to optimize treatment worldwide.
AB - Purpose: To ascertain the spectrum of clinical management of endometrial carcinoma (EC) the largest international survey was conducted to evaluate and identify differences worldwide. Methods: After validation of a 15-item questionnaire regarding surgical and adjuvant treatment of EC in Germany, an English-adapted questionnaire was put online and posted to all the major gynecological cancer Societies worldwide for further distribution commencing in 2010 and continued for 26 months. Results: A total of 618 Institutions around the world participated: Central Europe (CE), Southern Europe (SE), Northern Europe (NE), Asia and USA/Canada/UK. Both a therapeutic and staging value was attributed to systematic pelvic and paraaortic lymph node dissection (LND) in CE (74.6 %) and in Asia (67.2 %), as opposed to USA/UK where LND was mainly for staging purposes (53.5 %; p < 0.001). LND was performed up to the renal veins in CE in 86.8 %, in Asia in 80.8 %, in USA/UK in 51.2 % and in SE in 45.1 % (p < 0.001) of cases. In advanced disease, centers from Asia were treated most with adjuvant chemotherapy alone (93.6 %), as opposed to centers in SE, CE and UK/USA that employed combination chemo-radiotherapy in 90.9 % (p < 0.001) of cases. Paclitaxel/carboplatin was mostly used followed by doxorubicin/cisplatin (75 vs. 23.3 %; p < 0.001). In total, 94 % of all participants supported the concept of treating EC patients within appropriate clinical trials. Conclusions: There is broad range in both the surgical and adjuvant treatment of EC across different countries. Large-scale multicenter prospective trials are warranted to establish consistent, evidence-based guidelines to optimize treatment worldwide.
KW - Chemotherapy
KW - Endometrial cancer
KW - Lymph node dissection
KW - Survey
KW - Toxicity
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U2 - 10.1007/s00404-014-3510-3
DO - 10.1007/s00404-014-3510-3
M3 - Article
C2 - 25315381
AN - SCOPUS:84924778403
SN - 0932-0067
VL - 291
SP - 897
EP - 905
JO - Archives of Gynecology and Obstetrics
JF - Archives of Gynecology and Obstetrics
IS - 4
ER -