ESMO-ESGO-ESTRO Consensus Conference on Endometrial Cancer: Diagnosis, Treatment and Follow-up

Colombo, Nicoletta; Creutzberg, Carien L.; Amant, Frédéric; Bosse, Tjalling; González-Martín, Antonio; Ledermann, Jonathan A.; Marth, Christian; Nout, Remi A.; Querleu, Denis; Mirza, Mansoor Raza; Sessa, Cristiana

doi:10.1097/igc.0000000000000609

Cited by 628 publications

(602 citation statements)

References 213 publications

(312 reference statements)

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“…The standard management for apparently early stage disease is total hysterectomy and bilateral salpingo-oophorectomy (secondary to hormonal sensitivity of most endometrial cancer) with nodal assessment (sentinel lymph node mapping algorithm or pelvic ± para-aortic lymphadenectomy) (88, 89). …”

Section: Part V: Fertility-sparing Management Of Endometrial Cancermentioning

confidence: 99%

“…Fertility-sparing treatment is increasingly accepted as an alternative for young women who have disease limited to the endometrium and want to maintain their reproductive potential (88, 89). Patients should be counseled that conservative management is not a standard treatment and close follow-up is a must (88, 89).…”

Section: Part V: Fertility-sparing Management Of Endometrial Cancermentioning

confidence: 99%

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Fertility-sparing for young patients with gynecologic cancer: How MRI can guide patient selection prior to conservative management

et al. 2017

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Historically, cancer treatment has emphasized measures for the “cure” regardless of the long-term consequences. Advances in cancer detection and treatment have resulted in improved outcomes bringing to the fore various quality of life considerations including future fertility. For many young cancer patients, fertility preservation is now an integral component of clinical decision-making and treatment design. Optimal fertility-sparing options for young patients with gynecologic cancer are influenced by patient age, primary cancer, treatment regimens, and patient preferences. Possible approaches include embryo or oocyte cryopreservation, ovarian transposition, conservative surgery, and conservative medical treatment to delay radical surgery. These may be used alone or in combination to maximize fertility preservation. Awareness of the various fertility-sparing options, eligibility criteria, and the central role of Magnetic Resonance Imaging (MRI) in the proper selection of patients will enable radiologists to produce complete clinically relevant imaging reports and serve as effective consultants to referring clinicians. Knowledge of the potential imaging pitfalls is essential to avoid misinterpretation and guide appropriate management.

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Section: Part V: Fertility-sparing Management Of Endometrial Cancermentioning

confidence: 99%

Section: Part V: Fertility-sparing Management Of Endometrial Cancermentioning

confidence: 99%

Fertility-sparing for young patients with gynecologic cancer: How MRI can guide patient selection prior to conservative management

et al. 2017

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“…However, a significant proportion of patients are medically unfit for laparoscopic surgery or laparotomy. A reasonable alternative may be to perform vaginal hysterectomy, whenever possible, with bilateral salpingo-oophorectomy 1. Similar disease-free and overall survival outcomes have been reported for patients undergoing vaginal hysterectomy and those undergoing abdominal or laparoscopic hysterectomy 4–6.…”

Section: Introductionmentioning

confidence: 71%

Vaginal hysterectomy with or without bilateral salpingo-oophorectomy may be an alternative treatment for endometrial cancer patients with medical co-morbidities precluding standard surgical procedures: a systematic review

Kruse

Brugge

Haan

et al. 2019

Int J Gynecol Cancer

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ObjectiveVaginal hysterectomy with bilateral salpingo-oophorectomy may be an alternative strategy for patients with low-risk endometrial cancer and medical co-morbidities precluding laparoscopic or abdominal procedures. The current study evaluates the prevalence of co-existent ovarian malignancy in patients with endometrial cancer and the influence of bilateral salpingo-oophorectomy on survival outcomes in these patients.MethodsMedline and EMBASE were searched for studies published between January 1, 2000 and November 20, 2017 that investigated (1) the prevalence of co-existing ovarian malignancy (either metastases or primary synchronous ovarian cancer in women with endometrial cancer, and (2) the influence of bilateral salpingo-oophorectomy on recurrence and/or survival rates.ResultsOf the pre-menopausal and post-menopausal patients (n=6059), 373 were identified with metastases and 106 were identified with primary synchronous ovarian cancer. Of the post-menopausal patients (n=6016), 362 were identified with metastases and 44 were identified with primary synchronous ovarian cancer. Survival outcomes did not differ for pre-menopausal patients with endometrial cancer with and without bilateral salpingo-oophorectomy (5-year overall survival rates were 89–94.5% and 86–97.8%, respectively).ConclusionBilateral salpingo-oophorectomy during vaginal hysterectomy seems to have a limited impact on disease outcome in patients with endometrial cancer. These results support the view that vaginal hysterectomy alone or with bilateral salpingo-oophorectomy may be an option for patients with endometrial cancer who are not ideal surgical candidates.

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“…Raw prevalence indicator in all developed countries exceeds 26. This high number of cancers is mainly a result of the following risk factors: obesity, hypertension, diabetes, hormonal disorders or tamoxifene treatment and Lynch syndrome [5][6][7]. The prevalence of these ailments, common in modern societies, is increasing.…”

Section: Discussionmentioning

confidence: 99%

The assessment of overall survival (OS) after adjuvant chemotherapy for patients with malignant endometrial cancer in Poland

Teter¹,

Śliwczyński²,

Brzozowska³

et al. 2017

Ginekol Pol

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Objectives: In 2013 malignant endometrial cancers have amounted to 7.3% of all cancers diagnosed among women in the report by the Polish National Cancer Registry Raw prevalence rate amounted to 28.7, whereas standardised prevalence rate 15.6 per 100 000 population. Among the causes of death, these cancers amounted to 3% and were ranked ninth on the list of the most common causes of oncologic mortality of women. In the year 2013 a total of 1243 women died of malignant endometrial cancers. A stable increase of malignant endometrial cancer incidence has been observed for 2 decades. Despite that fact, the increase of the mortality incidence is at a much lower level, which demonstrates the much higher effectiveness of the treatment of such cancers. The recording rate of the malignant endometrial cancer mortality amounts to 95%, so the presented absolute numbers are reliable. Examining the clinical stages of malignant endometrial cancers, we can establish that approx. 85% of them are diagnosed at stage I or II according to the FIGO classification. Patients with advanced stages of cancer represent less than 15%.Material and methods: retrospective analysis of endometrial body cancer prevalence data for the entire population of Poland, assessment of malignant endometrial cancer prevalence in the years 2008-2015 and overall survival probability in the population of patients undergoing adjuvant chemotherapy. Results:The number of patients with a diagnosed malignant endometrial cancer within the studied period in Poland remains on a stable level (2008 -30.6 thousand patients, 2015 -40.2 thousand patients). Among all listed patients with the indication of C54 each year approx. 20% enters hospital treatment. System therapy with chemotherapy drugs was used in approx. 1-2% of patients treated in hospitals. The average age of the patients was 64.9 years, and the median age 65 years. The number of observations was 2085, including 1088 censored observations. The average survival for the sample under study was 30.67 month (SD = ± 0.6); median survival time was 23.93 month. The number of censored observations was 1088 (52.16%). Probable survival of 1 year is achieved by 67.57% of patients, 2 years by 49.73%, 3 years by 40.68%, above 5 years 30.77%. Conclusions:The incidence of endometrial cancer in Poland in the years 2008-2015 continues to grow at 5% upward trend (in Europe 3.4-5.9). In Poland in 2012, crude incidence rate for cancer of the uterus was 29.8 and did not differ significantly from the results in countries such as Finland, Slovakia, Sweden, Belgium and Bulgaria. The overall survival after adjuvant chemotherapy for patients with malignant endometrial cancer in Poland shows considerable differences depending on the region of the country.

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ESMO-ESGO-ESTRO Consensus Conference on Endometrial Cancer: Diagnosis, Treatment and Follow-up

Abstract: Supplemental digital content is available in the text.

Cited by 628 publications

References 213 publications

Fertility-sparing for young patients with gynecologic cancer: How MRI can guide patient selection prior to conservative management

Fertility-sparing for young patients with gynecologic cancer: How MRI can guide patient selection prior to conservative management

Vaginal hysterectomy with or without bilateral salpingo-oophorectomy may be an alternative treatment for endometrial cancer patients with medical co-morbidities precluding standard surgical procedures: a systematic review

The assessment of overall survival (OS) after adjuvant chemotherapy for patients with malignant endometrial cancer in Poland

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