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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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8/23/2019 2. Endometrial Cancer V1.2010 (en)
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ENDOMETRIAL CANCERCollege of OncologyNational Guidelines
College 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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V1.2010 2010 College of Oncology
8/23/2019 2. Endometrial Cancer V1.2010 (en)
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ENDOMETRIAL CANCERCollege of OncologyNational Guidelines
External reviewers
College of OncologyNational Guidelines
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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V1.2010 2010 College of Oncology
8/23/2019 2. Endometrial Cancer V1.2010 (en)
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ENDOMETRIAL CANCERCollege of OncologyNational Guidelines
Table of contentsCollege of OncologyNational Guidelines
Endometrial cancer guidelines expert panel External reviewers
Treatment algorithm: Clinical stage 1 National guidelines endometrial cancer (Full text)
nce
w
gy
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
College of OncologyNational Guidelines
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
V1.2010 2010 College of Oncology