2. endometrial cancer v1.2010 (en)

8/23/2019 2. Endometrial Cancer V1.2010 (en)

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ENDOMETRIAL CANCER

V1.2010 2010 College of Oncology

College of OncologyNational Guidelines

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ENDOMETRIAL CANCERCollege of OncologyNational Guidelines


Expert panel

Endometrial Cancer Guidelines Expert Panel

Prof. dr. Ignace Vergote

Coordinator National Guidelines Endometrial CancerUniversity Hospital Leuven

Prof. dr. Jean-Franois Baurain

Cliniques Universitaires Saint-Luc

Prof. Dr. Claire Bourgain

Universitair Ziekenhuis Brussel

Prof. dr. Jacques De GrveUniversitair Ziekenhuis Brussel

Prof. dr. Frdric KridelkaCentre Hospitalier Universitaire de Lige

Prof. dr. Pierre ScallietCliniques Universitaires Saint-Luc

Prof. dr. Philippe Simon

ULB Hpital Erasme Bruxelles

Prof. dr. Sigrid Stroobants

University Hospital Antwerp

Prof. dr. Peter Van Dam

St Augustinus GZA Antwerp

Prof. Dr. Erik Van LimbergenUniversity Hospital Leuven

Prof. dr. Geert VilleirsUniversity Hospital Ghent

Prof. dr . Marc PeetersChairman College of OncologyUniversity Hospital Antwerp

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External reviewers


External reviewers

Invited professional associations Reviewers

Belgian Society of Medical Oncology * Dr. Gino PelgrimsDr. Aldrik Nielander

Royal Belgian Radiological Society ** Prof. dr. Bart Op de Beeck

The Belgian Association of Clinical Cytology ** Prof. dr. John-Paul Borgers

Vlaamse Vereniging voor Obstetrie en Gynaecologie ** Dr. Koen Traen

Groupement des Gyncologues Obsttriciens de Langue Franais de Belgique ** Dr. Michel Coibion

Belgische Vereniging voor Radiotherapie-Oncologie - Association Belge de Radiothrapie *** -

Belgian Society of Pathology **** -

Domus Medica **** -

Socit Scientifique de Mdicine Gnrale **** -

* Two experts assigned and feedback received. *** Two experts assigned, but one feedback received.***One or two experts assigned, but no feedback received. ****No experts assigned

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Table of contentsCollege of OncologyNational Guidelines

Endometrial cancer guidelines expert panel External reviewers

Treatment algorithm: Clinical stage 1 National guidelines endometrial cancer (Full text)

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Diagnosis and stagingAppendix 2: Surgical FIGO 2009 staging

Introduction

Search for evide

External revie

Epidemiolo Screening

Treatment of operable patients Surgical FIGO-2009 stage I endometrioid carcinoma Surgical FIGO-2009 stage II endometrioid carcinoma Surgical FIGO-2009 stage III endometrioid carcinoma

Treatment of medically inoperable patients

Follow-up

Treatment of carcinosarcoma / clear cell carcinoma / serouscarcinoma

Treatment of recurrent disease

References Appendix 1: Histological subtypes



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Treatment algorithmClinical stage 1

Table of contents

Stage 1

Peroperative:

- no suspicious pelviclymph nodes

- no serosal infiltration- no adnexal metastases

Pelvic lymph nodespositive

No para-aortic

lymphadenectomy

2cm, G1and 2cm G2 or

> 2cm g1 > 1/3 infiltration

hysterectomyPeroperative:and- frozen section: positivepelvic lymph nodes

bilateral adnexectomyand

- or serosal infiltrationperitoneal cytology- or adnexal metastasesand

pelvic lymphadenectomy

Para-aortic

lymphadenectomy

Pelvic lymph nodesnegative

Para-aortic lymph nodesnegative

Para-aortic lymph nodespositive

If stage 1A and G1or G1

If stage 1B -

G2 or G3

Chemotherapy + pelvicand para-aortic

radiotherapy


No adjuvant Chemotherapy Sequential chemotherapy+ pelvic radiotherapytreatment o tional



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Appendix 1Histological subtypes

Table of contents

Histological subtypes

The histological subtype is an important prognostic factor. Frequency of endometrial cancer cell types is as follows:

1. Endometrioid (75%80%): The prognosis depends mainly on the staging. In stage 1 the prognosis depends on the depth of the

myometrial infiltration , histopathological grading, status of the lymph nodes and age.1. Ciliated adenocarcinoma

2. Secretory adenocarcinoma

3. Papillary or villoglandular

4. With squamous differentiation: The prognosis depends on the histopathological grading of the glandular component

2. Uterine papillary serous carcinoma (5-10%): 5-year survival 25%

3. Clear cell (4%): 5-year survival 40%

4. Mucinous (1%)

5. Squamous cell (


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Appendix 2FIGO Surgical Staging

Table of contents

FIGO Staging 2009 (surgical staging)

Stage I: Tumor confined to the corpus uteriStage Ia G 123 : no invasion or < of the myometriumStage Ib G 123 : invasion of of the myometrium

Stage II: Tumor invades cervical stroma (but does not extend beyond the uterus). Endocervical epithelial involvement only is classified asstage I.

Stage III: Local and/or regional spread of the tumorStage IIIa G 123 : invasion of the serosa and/or adnexes (positive peritoneal cytology has to be reported separately and is in itself not

sufficient to be classified as stage III)Stage IIIb G 123 : Invasion of the vagina or parametriaStage IIIc G 123 : pelvic and/or para-aortic lymph nodes metastasis

IIIc1: Pelvic lymph nodes metastasisIIIc2: Para-aortic lymph nodes metastasis

Stage IV: Tumor invades bladder mucosa and/or bowel mucosa, and/or distant metastasisStage IVa G 123 : invasion of bladder mucosa and/or bowel mucosaStage IVb G 123 : distant metastasis with involvement of intra-abdominal and/or inguinal lymph nodes

G1, 2 of 3 is the histopathological grading


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