1. Endometrial cancer: A society of gynecologic oncology evidence-based review and recommendations.
- Author
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Hamilton, Chad A., Pothuri, Bhavana, Arend, Rebecca C., Backes, Floor J., Gehrig, Paola A., Soliman, Pamela T., Thompson, J. Spencer, Urban, Renata R., and Burke, William M.
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ENDOMETRIAL cancer , *GYNECOLOGIC oncology , *GYNECOLOGIC cancer , *LYMPH node surgery , *MOLECULAR pathology , *MINIMALLY invasive procedures - Abstract
In 2014, the Society of Gynecologic Oncology's Clinical Practice Committee published a clinical update reviewing the treatment of women with endometrial cancer. At that time, there had been significant advances in the diagnosis, work-up, surgical management, and available treatment options allowing for more optimal care of affected women. Despite these advances, the incidence of endometrial cancer as well as the deaths attributable to the disease have continued to rise; from 1987 to 2014 there has been a 75% increase in cases and almost 300% increase in endometrial cancer deaths. Fortunately, since then, there has been progress in the treatment of patients with endometrial cancer with increased utilization of molecular pathology, greater understanding of genetic predisposition, enhanced methods for lymph node assessment, a broader understanding of the efficacy of radiation and chemotherapy, and a more efficient approach to survivorship and surveillance. The purpose of this document is to present a comprehensive review of this progress. The authors reviewed the available evidence, contributed to the development of this manuscript, provided critical review of the guidelines, and finalized the manuscript recommendations. The review was also presented to and approved by the Society of Gynecologic Oncology (SGO) Clinical Practice Committee, SGO Publications Committee, and the SGO board members prior to submission for publication. The recommendations for this manuscript were developed by a panel of gynecologic oncologists who were members of the SGO Clinical Practice and Education Committees. Panelists reviewed and considered evidence from current uterine cancer literature. The terminology used in these guidelines was adopted from the ASCCP management guidelines 1 using a two-part rating system to grade the strength of recommendation and quality of evidence (Table 1). The rating for each recommendation is given in parentheses. • Advances in molecular pathology complement clinical management of endometrial cancer. • Increased estrogen exposure and genetic predisposition remain important risk factors • Judicious evaluation of abnormal bleeding and cancer referrals to gynecologic oncologists optimize management • Most patients benefit from minimally invasive surgery and tailored lymph node evaluation. • Risk stratification based on recent trials should influence adjuvant therapy decisions. [ABSTRACT FROM AUTHOR]
- Published
- 2021
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