Martínez Alejandra, Chargari Cyrus, Kalbacher Elsa, Gaillard Anne-Lise, Leary Alexandra, Koskas Martin, Chopin Nicolás, Serre Anne-Agathe, Hardy-Bessard Anne-Claire, Akladios Chérif, Lecuru Fabrice
Département de chirurgie oncologique, institut Claudius-Regaud, institut universitaire du cancer Toulouse Oncopole, France; Centre de recherche en cancérologie de Toulouse, UMR 1037 INSERM, France.
Département d'oncologie-radiothérapie, hôpital de la Pitié Salpêtrière, France.
Bull Cancer. 2023 Jun;110(6S):6S20-6S33. doi: 10.1016/S0007-4551(23)00331-4.
Recommendations for clinical practice, Nice/Saint-Paul-de-Vence 2022-2023: Management of localized endometrial cancer Endometrial cancer is the most frequent gynecological cancers in industrialized countries and its incidence increases. The newmolecularclassification allows determination of the risk of recurrence and helps orienting therapeutic management. Surgery remains the cornerstone of treatment. Minimally invasive approach must be preferred for stages I and II. Surgery includes hysterectomy with bilateral adnexectomy, sentinel lymph node biopsy even in high risk diseases and omentectomy for non-endometrioid tumors (except in case of clear cells tumors). Fertility preservation can be proposed in low grade, stage I tumors without myometrial involvement. In stage III/IV disease, lymph node debulking without totallymphadenectomy is indicated. In case of peritoneal carcinomatosis, first-line cytoreductive surgery is recommended if complete resection can be achieved. Adjuvant therapy is not recommended in low risk tumors. In intermediate risk tumors, curietherapy is indicated. In tumors with high-intermediate risk, curietherapy and external radiotherapy are indicated according to prognostic factors (stage II, lymphovascular invasion); adjuvant chemotherapy can be considered on a case-by-case basis. In high risk tumors, chemotherapy and external radiotherapy are recommended using a concomitant or sequential approach.
