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Objectif : Evaluer l’application des recommandations de l’Institut national du cancer concernant la prise en charge diagnostique et therapeutique du cancer de l’endometre. Methodes Etude retrospective observationnelle portant sur 137 patientes traitees pour un cancer de l’endometre entre 2011 et 2013. Resultats : Le bilan preoperatoire etait conforme aux recommandations dans 66,4 % des cas et sous-estimait le risque d’envahissement ganglionnaire dans 44,9 % des cas. La sous-estimation du risque sur le bilan preoperatoire entrainait une sous-stadification chirurgicale dans 26,3 % des cas. Conclusion Pour ameliorer la pertinence du bilan preoperatoire dans le cancer de l’endometre, une expertise radiologique et anatomopathologique est necessaire sur le meme modele que ce qui est reclame pour la prise en charge chirurgicale. Cependant, meme realisee de maniere optimale, l’evaluation preoperatoire peine a proposer une stratification du risque d’envahissement ganglionnaire satisfaisante dans le cancer de l’endometre poussant a modifier les prises en charge chirurgicales recommandees en associant par exemple le prelevement du ganglion sentinelle en association a l’hysterectomie dans les cancers de l’endometre estimes a bas risque. [Objective: To assess the use of French Cancer Institute recommendations for the diagnosis and treatment of endometrial cancer. Methods Retrospective observational study involving 137 patients with endometrial cancer between 2011 and 2013. Results: Both MRI and pathological assessment with correct report as recommended were used for 66.4% of patients with endometrial cancer. For patients with correct preoperative assessment, 44.9% of patients were uncorrectly classified and upgraded on final pathological analysis of hysterectomy concerning lymph node involvement risk. These patients did not have confident surgical assessment, according this risk. Conclusion To improve relevance of preoperative assessment in endometrial cancer, radiological and pathological expertise is required. However, even performed optimally, preoperative assessment does not allow correct risk stratification of lymph node involvement in endometrial cancer. This ineffective stratification leads to propose sentinel lymph node biopsy with hysterectomy in case of preoperative low risk endometrial cancer assessment]

The endometrial cancers are mainly discovered at an early stage justifying a less aggressive treatment. The therapeutic choices are today based on preoperative classifications themselves based on histo-prognostic factors of the tumor and its extension measured in MRI: consequently, lymph node dissection in case of low and intermediate risk cancer is not systematically achieved. But a number of patients have lymph node involvement finally, probably justifying an adapted surgical and adjuvant treatment. The technique of sentinel node would compensate the weaknesses of preoperative prognostic evaluation. This new operative technique needs to be precised and evaluated: the topics subject to discussion are the technical implementation, the definition of its quality standards and the management of its histological results especially in cases of low volume lymph node metastasis.