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[欧洲子宫内膜癌管理指南(ESMO-ESGO-ESTRO 共识会议)]

[European guidelines (ESMO-ESGO-ESTRO consensus conference) for the management of endometrial cancer].

作者信息

Ballester Marcos, Bendifallah Sofiane, Daraï Emile

机构信息

AP-HP, université Pierre-et-Marie-Curie, hôpital Tenon, service de gynécologie-obstétrique, 4, rue de la Chine, 75020 Paris, France.

AP-HP, université Pierre-et-Marie-Curie, hôpital Tenon, service de gynécologie-obstétrique, 4, rue de la Chine, 75020 Paris, France.

出版信息

Bull Cancer. 2017 Dec;104(12):1032-1038. doi: 10.1016/j.bulcan.2017.10.006. Epub 2017 Nov 23.

Abstract

Endometrial cancer (EC) is a major source of morbidity and mortality in women worldwide. In France, in 2015, EC was the first gynecological cancer in terms of incidence. Its prognosis is considered favorable because it is most often limited to the uterus at diagnosis. Nevertheless, it is a heterogeneous pathology and 5-year overall survival can vary from 92 % to 42 % in FIGO stage I depending on its histological characteristics. This great heterogeneity leads to important disparities in its surgical management as well as in indications for adjuvant therapies. A consensus conference including three different European learned societies (ESMO-ESGO-ESTRO) has recently established new recommendations in order to standardize its management. One of the main points is the emergence of a new subgroup of patients at risk of recurrence (high-intermediate risk group). Concerning nodal staging, indications are still somewhat blurred for intermediate and high-intermediate risk groups. The sentinel lymph node biopsy remains an experimental procedure in contrast with American guidelines. Concerning adjuvant therapies, the place of chemotherapy and its combination with external beam radiotherapy should be explored, especially for patients with high risk EC and for certain histological subtypes.

摘要

子宫内膜癌(EC)是全球女性发病和死亡的主要原因。在法国,2015年,EC的发病率在妇科癌症中位居首位。其预后被认为较好,因为在诊断时它大多局限于子宫。然而,它是一种异质性疾病,根据其组织学特征,国际妇产科联盟(FIGO)I期患者的5年总生存率在92%至42%之间波动。这种巨大的异质性导致其手术治疗以及辅助治疗指征存在重大差异。最近,一个由三个不同的欧洲学术团体(欧洲肿瘤内科学会 - 欧洲妇科肿瘤学会 - 欧洲放射肿瘤学会,ESMO - ESGO - ESTRO)参与的共识会议制定了新的建议,以规范其治疗。其中一个要点是出现了一个新的复发风险亚组(高中风险组)。关于淋巴结分期,中风险组和高中风险组的指征仍有些模糊。与美国指南相比,前哨淋巴结活检仍是一种试验性手术。关于辅助治疗,应探索化疗的地位及其与体外放射治疗的联合应用,特别是对于高危EC患者和某些组织学亚型。

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