Guideline gynekologických zhoubných nádorů 2010
Primární chirurgická léčba zhoubných nádorů endometria

Czech version

Authors: B. Svoboda ¹; P. Líbalová ¹; M. Kubecová ²; L. Rob ³ ; P. Freitag ⁴; R. Pilka ⁵; J. Chovanec ⁶; K. Tikovský ¹; Z. Vernerová ⁷
Authors‘ workplace: Gynekologicko-porodnická klinika 3. LF UK a FN KV, Praha, přednosta doc. MUDr. B. Svoboda, CSc. ¹; Radioterapeutická a onkologická klinika 3. LF UK a FN KV, Praha, přednostka MUDr. M. Kubecová, Ph. D. ²; Gynekologicko-porodnická klinika 2. LF UK a FN Motol, Praha, přednosta prof. MUDr. L. Rob, CSc. ³; Gynekologicko-porodnická klinika 1. LF UK a VFN, Praha, přednosta prof. MUDr. A. Martan, DrSc. ⁴; Porodnicko-gynekologická klinika FN a LF UP, Olomouc, přednosta doc. MUDr. R. Pilka, Ph. D. ⁵; Oddělení gynekologické onkologie MOÚ, Brno, primář doc. MUDr. J. Chovanec, Ph. D. ⁶; Ústav patologie 3. LF UK a FN KV, Praha, přednosta prof. MUDr. V. Mandys, CSc. ⁷
Published in: Ceska Gynekol 2011; 76(3): 208-215

Overview

Objective:
To develop guideline for primary surgical treatment of endometrial carcinoma.

Design:
Review, consensus of expert group.

Setting:
Dept. of Gynaecology and Obstetrics, 3rd Medical Faculty of Charles University in Prague.

Method:
A retrospective review of published data, analysis of statistic data from Czech Republic, consensus among proposers and opponents.

Results:
The guideline recognizes endometrial carcinoma patients based on their risk and recommends type of surgical treatment for certain group. It emphasizes the importance of centralized oncogynaecological treatment. Surgical staging remains the basic principle for treatment of endometrial carcinoma patients. The aim of pre-operative diagnostics is to estimate the extent of the disease – “interim staging”, that can be different from definitive histopathological staging. Based on risk factors patients are divided into low or high risk group. Standard procedure for low risk patients is hysterectomy and bilateral salpingoophorectomy. It is advisable to use peroperative biopsy in these patients that can shift the patient to high risk group. High risk patients are recommended for hysterectomy, bilateral salpingoophorectomy, and systematic aortopelvic lymphadenectomy. The guideline contains recommendation for young patients wishing to preserve their fertility, for cases of inadequate surgery and for follow-up.

Conclusion:
Guideline for treatment of endometrial carcinoma is recommendation for clinicians and other subjects who participate on the process of the diagnostics/treatment of endometrial carcinoma patients. All points of the guideline were discussed and voted about by all participants of expert group.

Key words:
endometrial carcinoma, guideline, surgery, follow-up.

Sources

1. Creasman, W. Revised FIGO staging for carcinoma of the endometrium. Int J Gyn Obstet, 2009, 105, p. 109.

2. Mariani, A., Dowdy, SC., Keeney, GL., et al. High-risk endometrial cancer subgroups: candidates for target-based adjuvant therapy. Gyn Oncol, 2004, 95, p. 120-126.

3. Mariani, A., Webb, MJ., Keeney, GL., et al. Surgical stage I endometrial cancer: predictors of distant failure and death. Gyn Oncol, 2002, 87, p. 274-280.

4. Mariani, A., Dowdy, SC., Cliby, WA., et al. Prospective assessment of lymphatic dissemination in endometrial cancer: A paradigm shift in surgical staging. Gyn Oncol, 2008, 109, p. 11‑18.

5. Mariani, A., Dowdy, SC., Podratz, KC. New surgical staging of endometrial cancer: 20 years later. Int J Gyn Obstet, 2009, 105, p. 110-111.

6. Pecorelli, S. Revised FIGO staging for carcinoma of the vulva, cervix, and endometrium. Int Gynaecol Obstet, 2009, 105, 2, p. 103-104.

7. Quinlivan, JA., Petersen, RW., Nicklin, JL. Accuracy of frozen section for the operative management of endometrial cancer. BJOG, 2001, 108, p. 798-803.

8. van Holsbeke, C., Daemen, A., Yazbek, J., et al. Ultrasound methods to distinguish between malignant and benign adnexal masses in the hands of examiners with different levels of experience. Ultrasound Obstet Gynecol, 2009, 34, 4, p. 454-461. PubMed PMID: 19736644.