D Querleu1, E Darai2, F Lecuru3, A Rafii4, E Chereau5, P Collinet6, P Crochet7, H Marret8, E Mery9, L Thomas10, V Villefranque11, A Floquet10, F Planchamp10. 1. Institut Bergonié, 229, cours de l'Argonne, 33000 Bordeaux, France. Electronic address: denis.querleu@esgo.org. 2. Service de gynécologie-obstétrique et médecine de la reproduction, hôpital Tenon, AP-HP, 4, rue de la Chine, 75020 Paris, France. 3. Service de cancérologie gynécologique et du sein, hôpital européen Georges-Pompidou, AP-HP, 20, rue Leblanc, 75015 Paris, France. 4. Weill Cornell Medicine, Education City, Al Lugta St, Ar-Rayyan, Qatar; Service de gynécologie-obstétrique, hôpital Foch, 40, rue Worth, 92151 Suresnes, France. 5. Hôpital privé Beauregard, 23, rue des Linots, 13001 Marseille, France. 6. Clinique de gynécologie, hôpital Jeanne-de-Flandre, centre hospitalier régional universitaire, 59037 Lille cedex, France. 7. Service de gynécologie-obstétrique, hôpital de la Conception, AP-HM, 147, boulevard Baille, 13005 Marseille, France. 8. Pôle de gynécologie-obstétrique, service de chirurgie pelvienne gynécologique et oncologique, centre hospitalier universitaire Bretonneau, 2, boulevard Tonnellé, 37044 Tours cedex 1, France. 9. Institut Claudius-Regaud, IUCT Oncopole, 1, avenue Irène-Joliot-Curie, 31100 Toulouse, France. 10. Institut Bergonié, 229, cours de l'Argonne, 33000 Bordeaux, France. 11. Service de gynécologie-obstétrique, centre hospitalier René-Dubos, 6, avenue de l'Île-de-France, 95300 Pontoise, France.
Abstract
OBJECTIVES: The management of endometrial carcinoma is constantly evolving. The SFOG and the CNGOF decided to jointly update the previous French recommendations (Institut national du cancer 2011) and to adapt to the French practice the 2015 recommendations elaborated at the time of joint European consensus conference with the participation of the three concerned European societies (ESGO, ESTRO, ESMO). MATERIAL AND METHODS: A strict methodology was used. A steering committee was put together. A systematic review of the literature since 2011 has been carried out. A first draft of the recommendations has been elaborated, with emphasis on high level of evidence. An external review by users representing all the concerned discipines and all kinds of practice was completed. Three hundred and four comments were sent by 54 reviewers. RESULTS: The management of endometrial carcinoma requires a precise preoperative workup. A provisional estimate of the final stage is provided. This estimation impact the level of surgical staging. Surgery should use a minimal invasive approach. The final pathology is the key of the decision concerning adjuvant therapy, which involves surveillance, radiation therapy, brachytherapy, or chemotherapy. CONCLUSION: The management algorithms allow a fast, state of the art based, answer to the clinical questions raised by the management of endometrial cancer. They must be used only in the setting of a multidisciplinary team at all stages of the management.
OBJECTIVES: The management of endometrial carcinoma is constantly evolving. The SFOG and the CNGOF decided to jointly update the previous French recommendations (Institut national du cancer 2011) and to adapt to the French practice the 2015 recommendations elaborated at the time of joint European consensus conference with the participation of the three concerned European societies (ESGO, ESTRO, ESMO). MATERIAL AND METHODS: A strict methodology was used. A steering committee was put together. A systematic review of the literature since 2011 has been carried out. A first draft of the recommendations has been elaborated, with emphasis on high level of evidence. An external review by users representing all the concerned discipines and all kinds of practice was completed. Three hundred and four comments were sent by 54 reviewers. RESULTS: The management of endometrial carcinoma requires a precise preoperative workup. A provisional estimate of the final stage is provided. This estimation impact the level of surgical staging. Surgery should use a minimal invasive approach. The final pathology is the key of the decision concerning adjuvant therapy, which involves surveillance, radiation therapy, brachytherapy, or chemotherapy. CONCLUSION: The management algorithms allow a fast, state of the art based, answer to the clinical questions raised by the management of endometrial cancer. They must be used only in the setting of a multidisciplinary team at all stages of the management.