Maggino T, Romagnolo C, Landoni F, Sartori E, Zola P, Gadducci A
Obstetrics and Gynecology Institute, University of Padova, Italy.
Gynecol Oncol. 1998 Mar;68(3):274-9. doi: 10.1006/gyno.1998.4951.
The aim of this study was to define the clinical-therapeutical approach to endometrial cancer now being followed in some of the most important centers of reference for gynecological cancer in North America by means of a questionnaire.
The questionnaire focused on four principal areas: (1) surgical staging and therapy; (2) adjuvant treatment; (3) treatment modifications; and (4) management of advanced stages (FIGO III-IV).
There were 48 evaluable responses (77%) received by the end of December 1994 which were considered for this analysis. Lymphadenectomy is utilized routinely in 26/48 centers (54.2%) and in selective clinical-pathological conditions in another 21/48 centers (43.5%). In the majority of centers (31/48; 64.6%) radical surgery is utilized for selected indications such as cervical involvement. Only 3/48 (6.2%) centers consider the vaginal approach totally inappropriate. The great majority (40/48; 83.3%) of the centers considered postsurgical adjuvant therapy to be necessary in FIGO Stage Ic. Brachytherapy is routinely performed in 3 centers (6.2%) in postsurgical management of Stage I endometrial cancer, while the majority of the centers (31/48; 64.6%) perform brachytherapy of the vaginal vault in certain clinical-pathological conditions. A wide variety of treatments are used for advanced stages (FIGO III-IV).
It emerges that some controversial aspects exist on endometrial cancer treatment, and these conflicting data need a large-scale multicenter randomized clinical trial.
本研究旨在通过问卷调查明确北美一些妇科癌症重要参考中心目前对子宫内膜癌所采用的临床治疗方法。
问卷聚焦于四个主要方面：（1）手术分期与治疗；（2）辅助治疗；（3）治疗调整；（4）晚期（国际妇产科联盟III - IV期）的管理。
截至1994年12月底共收到48份可评估回复（77%），用于本分析。26/48个中心（54.2%）常规进行淋巴结切除术，另外21/48个中心（43.5%）在特定临床病理情况下进行。大多数中心（31/48；64.6%）对某些指征（如宫颈受累）采用根治性手术。只有3/48（6.2%）个中心认为经阴道途径完全不合适。绝大多数（40/48；83.3%）中心认为国际妇产科联盟Ic期术后辅助治疗是必要的。3个中心（6.2%）在I期子宫内膜癌术后管理中常规进行近距离放疗，而大多数中心（31/48；64.6%）在特定临床病理情况下对阴道穹窿进行近距离放疗。晚期（国际妇产科联盟III - IV期）采用多种治疗方法。
子宫内膜癌治疗存在一些有争议的方面，这些相互矛盾的数据需要大规模多中心随机临床试验。
