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Surgical and systemic management of endometrial cancer: an international survey

  • Gynecologic Oncology
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

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.

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Acknowledgements

We thank the ENGOT society for its support in this survey.

Conflict of interest

No financial or personal conflict of interest by any of the authors to declare.

Author information

Authors and Affiliations

  1. Frauenklinik, Universitätsklinik Charite, Campus Virchow, Berlin, Germany

    Christina Fotopoulou, Robert Kraetschell & Jalid Sehouli

  2. Ovarian Cancer Action Research Centre, Imperial College London, London, UK

    Christina Fotopoulou

  3. Mayo Clinic College of Medicine, Rochester, MN, USA

    Sean Dowdy

  4. Saitama International Medical Center, Saitama Medical University, Saitama, Japan

    Keiichi Fujiwara

  5. Tohoku University, Sendai, Japan

    Nobuo Yaegashi

  6. National Cancer Institute, Milan, Italy

    Domenica Larusso

  7. San Carlos University, Madrid, Spain

    Antonio Casado

  8. Universitätsklinikum Hamburg-Eppendorf, Hamburg, Germany

    Sven Mahner

  9. Columbia University Medical Center, New York, USA

    Thomas J. Herzog

  10. School of Cancer Sciences, University of Birmingham, Birmingham, UK

    Sean Kehoe

  11. Catholic University of Leuven, Louvain, Belgium

    Ignace Vergote

  12. University of Texas Southwestern Medical Center, Dallas, TX, USA

    David Scott Miller

  13. Universitätsklinik für Frauenheilkunde, Innsbruck, Austria

    Christian Marth

  14. Kitano Hospital Tazuke Kofukai Medical Research Institute, Ohgimachi, Kita-Ku, Osaka, Japan

    Shingo Fujii

  15. Department of Gynecology, Charité, Campus Virchow Clinic-University Hospital, Augustenburger Platz 1, 13353, Berlin, Germany

    Jalid Sehouli

Authors
  1. Christina Fotopoulou
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  2. Robert Kraetschell
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  3. Sean Dowdy
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  4. Keiichi Fujiwara
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  7. Antonio Casado
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  8. Sven Mahner
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  9. Thomas J. Herzog
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  11. Ignace Vergote
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  12. David Scott Miller
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  13. Christian Marth
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  14. Shingo Fujii
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  15. Jalid Sehouli
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Corresponding author

Correspondence to Christina Fotopoulou.

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Fotopoulou, C., Kraetschell, R., Dowdy, S. et al. Surgical and systemic management of endometrial cancer: an international survey. Arch Gynecol Obstet 291, 897–905 (2015). https://doi.org/10.1007/s00404-014-3510-3

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  • DOI: https://doi.org/10.1007/s00404-014-3510-3

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