Querleu D, Darai E, Lecuru F, Rafii A, Chereau E, Collinet P, Crochet P, Marret H, Mery E, Thomas L, Villefranque V, Floquet A, Planchamp F
Institut Bergonié, 229, cours de l'Argonne, 33000 Bordeaux, France.
Service de gynécologie-obstétrique et médecine de la reproduction, hôpital Tenon, AP-HP, 4, rue de la Chine, 75020 Paris, France.
Gynecol Obstet Fertil Senol. 2017 Dec;45(12):715-725. doi: 10.1016/j.gofs.2017.10.008. Epub 2017 Nov 11.
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).
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.
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.
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.
子宫内膜癌的管理方法在不断演变。法国妇产科肿瘤学会（SFOG）和法国妇科肿瘤协作组（CNGOF）决定联合更新之前的法国建议（法国国家癌症研究所，2011年），并使2015年在欧洲三个相关学会（欧洲妇科肿瘤学会、欧洲放射肿瘤学会、欧洲肿瘤内科学会）参与的联合欧洲共识会议上制定的建议适用于法国的实际情况。
采用了严格的方法。组建了一个指导委员会。对2011年以来的文献进行了系统回顾。制定了建议的初稿，重点关注高证据水平。完成了由代表所有相关学科和各类实际情况的使用者进行的外部评审。54名评审员共发送了304条意见。
子宫内膜癌的管理需要精确的术前检查。提供了最终分期的初步估计。这一估计会影响手术分期的水平。手术应采用微创方法。最终病理是决定辅助治疗的关键，辅助治疗包括监测、放射治疗、近距离放射治疗或化疗。
管理算法能够基于最新技术快速解答子宫内膜癌管理中提出的临床问题。在管理的各个阶段，必须仅在多学科团队的背景下使用这些算法。
