Scattarelli Antoine, Poteau Albane, Aziz Moutaz, Lae Marick, Courville Philippe, Arnaud Maxime, Marpeau Loic, Resch Benoit
Département de chirurgie gynécologique, CHU Rouen, 37, boulevard Gambetta, 76000 Rouen, France.
Département de chirurgie, CLCC Henri Becquerel, Rue d'Amiens, Rouen, France.
Bull Cancer. 2020 Dec;107(12):1221-1232. doi: 10.1016/j.bulcan.2020.08.006. Epub 2020 Oct 6.
Non endometrioid endometrial cancer are infrequent and have poor prognosis. The aim of the study was to evaluate non endometrioid endometrial cancer managment by evaluating endometrial cancer guidelines application.
This multicentric retrospective study enrolled non endometrioid endometrial cancer between January 2009 to December 2019. Analyses adapted at last French guidelines applicated corresponding of year management.
Seventy-four non endometrioid endometrial cancer analysed in 10 centers: 34 carcinosarcoma (45,9 %), 29 serous carcinoma (39,2 %), 9 clear cells carcinoma (12,2 %) and 2 undifferentiated carcinoma (2,7 %). For initial management, endometrial cancer guidelines applicated to 45,9 %. First reason of initial guidelines « non-application » was lack of surgical lymph node stadification (57,1 %). For adjuvant management, endometrial cancer guidelines applicated to 38.7 %. First reason of adjuvant guidelines « non-application » was lack lymph node stadification to complete staging when it previously incompletly operated (67,6 %).
Non endometrioid endometrial cancer guidelines applicability is difficult. This explicated by high age and comorbidity when surgical lymph node stadification is necessary. Using new staging technic will allow target management and better select lymph node staging indication.
非子宫内膜样子宫内膜癌并不常见,预后较差。本研究的目的是通过评估子宫内膜癌指南的应用情况来评价非子宫内膜样子宫内膜癌的管理。
这项多中心回顾性研究纳入了2009年1月至2019年12月期间的非子宫内膜样子宫内膜癌患者。分析采用了最后适用的法国指南,对应相应年份的管理。
在10个中心分析了74例非子宫内膜样子宫内膜癌:34例癌肉瘤(45.9%),29例浆液性癌(39.2%),9例透明细胞癌(12.2%)和2例未分化癌(2.7%)。对于初始治疗,子宫内膜癌指南的适用率为45.9%。初始指南“未应用”的首要原因是缺乏手术淋巴结分期(57.1%)。对于辅助治疗,子宫内膜癌指南的适用率为38.7%。辅助指南“未应用”的首要原因是先前手术分期不完全时缺乏淋巴结分期以完成分期(67.6%)。
非子宫内膜样子宫内膜癌指南的适用性较差。这是由于在需要进行手术淋巴结分期时患者年龄较大且合并症较多。采用新的分期技术将有助于进行针对性管理并更好地选择淋巴结分期指征。