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.
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.
Authors: R A Nout; V T H B M Smit; H Putter; I M Jürgenliemk-Schulz; J J Jobsen; L C H W Lutgens; E M van der Steen-Banasik; J W M Mens; A Slot; M C Stenfert Kroese; B N F M van Bunningen; A C Ansink; W L J van Putten; C L Creutzberg Journal: Lancet Date: 2010-03-06 Impact factor: 79.321
Authors: Carien L Creutzberg; Wim L J van Putten; Peter C Koper; Marnix L M Lybeert; Jan J Jobsen; Carla C Wárlám-Rodenhuis; Karin A J De Winter; Ludy C H W Lutgens; Alfons C M van den Bergh; Elzbieta van der Steen-Banasik; Henk Beerman; Mat van Lent Journal: Gynecol Oncol Date: 2003-05 Impact factor: 5.482
Authors: Jamie N Bakkum-Gamez; Jesus Gonzalez-Bosquet; Nadia N Laack; Andrea Mariani; Sean C Dowdy Journal: Mayo Clin Proc Date: 2008-01 Impact factor: 7.616
Authors: Andrea Mariani; Sean C Dowdy; William A Cliby; Bobbie S Gostout; Monica B Jones; Timothy O Wilson; Karl C Podratz Journal: Gynecol Oncol Date: 2008-03-04 Impact factor: 5.482