Burke William M, Orr James, Leitao Mario, Salom Emery, Gehrig Paola, Olawaiye Alexander B, Brewer Molly, Boruta Dave, Herzog Thomas J, Shahin Fadi Abu
Division of Gynecologic Oncology, Valley Hospital, Paramus, NJ, USA; Columbia University Medical Center, New York, NY, USA.
Florida Gynecologic Oncology, Fort Myers, FL, USA.
Gynecol Oncol. 2014 Aug;134(2):393-402. doi: 10.1016/j.ygyno.2014.06.003. Epub 2014 Jun 11.
Endometrial carcinoma is the most common gynecologic malignancy. A thorough understanding of the epidemiology, pathophysiology, and management strategies for this cancer allows the obstetrician-gynecologist to identify women at increased risk, contribute toward risk reduction, and facilitate early diagnosis. The Society of Gynecologic Oncology's Clinical Practice Committee has reviewed the literature through March of 2014 and created evidence-based practice recommendations for diagnosis and treatment. The level of recommendations used is based on the method used by the U.S. Preventive Services Task Force (A: There is good evidence to support the recommendation, B: There is fair evidence to support the recommendation, C: There is insufficient evidence to support the recommendation; however, the recommendation may be made on other grounds, D: There is fair evidence against the recommendation, E: There is good evidence against the recommendation.). It is not the purpose of this document to provide a complete review of the literature on all aspects of endometrial cancer. This article examines: • Adjuvant therapy, including radiation, vaginal brachytherapy, and chemotherapy • Therapy for advanced disease, including chemotherapy and radiation therapy alone and in combination as well as hormone therapy • Treatment for synchronous endometrial and ovarian cancer • Fertility-sparing treatment • Post-treatment patient surveillance • The role of hormone replacement therapy in the development of endometrial carcinoma • Novel targeted therapies.
子宫内膜癌是最常见的妇科恶性肿瘤。深入了解这种癌症的流行病学、病理生理学和管理策略，有助于妇产科医生识别风险增加的女性，降低风险，并促进早期诊断。妇科肿瘤学会临床实践委员会回顾了截至2014年3月的文献，并制定了基于证据的诊断和治疗实践建议。所采用的建议级别基于美国预防服务工作组使用的方法（A：有充分证据支持该建议；B：有合理证据支持该建议；C：证据不足，但可基于其他理由提出该建议；D：有合理证据反对该建议；E：有充分证据反对该建议）。本文的目的并非全面回顾有关子宫内膜癌各个方面的文献。本文探讨：•辅助治疗，包括放疗、阴道近距离放疗和化疗；•晚期疾病的治疗，包括单独及联合使用的化疗和放疗以及激素治疗；•同步子宫内膜癌和卵巢癌的治疗；•保留生育功能的治疗；•治疗后患者监测；•激素替代疗法在子宫内膜癌发生中的作用；•新型靶向治疗。
