Controversies in the management of endometrial cancer: a survey of the Korean Gynecologic Oncology Group

Abstract

ObjectiveTo identify current practice patterns for unresolved issues in the surgical and adjuvant management of endometrial cancer in Korea.MethodsWe designed and conducted a survey of all 218 active members of the Korean Gynecologic Oncology Group to try to identify how they would manage various case scenarios for endometrial cancer. Data were collected using an Internet survey database.ResultsA total of 108 members (49.5%) responded to the survey. Laparoscopy (81.6%) was the most commonly used mode of surgery in early-stage endometrial cancer. Of all the respondents, 19.8% stated that lymphadenectomy could be omitted and 21.7% recommended selective lymphadenectomy based on sentinel biopsy or frozen results for patients with presumed stage IA/grade 1 disease. On the other hand, 71.9% of respondents recommended para-aortic lymphadenectomy for patients with presumed stage IB/grade 1 disease and 86.4% recommended this treatment for presumed stage IB/grade 3 disease. The majority of respondents performed adjuvant therapy for stage IB/grade 2 (91.7%), IB/grade 3 (99.0%), and stage II (89.6%). Whole pelvic radiotherapy and vaginal brachytherapy were the most frequently used options among these patients. All respondents administered adjuvant therapy when node metastasis was found, and concurrent chemoradiotherapy (53.2%) was the most preferred option for stage IIIC1 disease.ConclusionThere is broad variation in both the surgical and adjuvant treatment of endometrial cancer among Korean gynecologic oncologists.

Oncologic Outcomes After Adjuvant Radiotherapy for Stage II Endometrial Carcinoma: A Korean Radiation Oncology Group Study (KROG 14–10)

“…6 With regard to postoperative treatment, the type of RT (external beam RT [EBRT] or vaginal brachytherapy [VBT] or a combination) to be administered and the patient subgroup that would benefit most from adjuvant treatment are unclear. Moreover, it is unclear whether RTor chemotherapy is better as an adjuvant treatment for stage II EC.…”

Dilatation and curettage is more accurate than endometrial aspiration biopsy in early-stage endometrial cancer patients treated with high dose oral progestin and levonorgestrel intrauterine system

“…It rarely invades the extrauterine organs and myometrium [4212223]. The standard treatment of EC includes total hysterectomy, bilateral salpingo-oophorectomy, peritoneal cytology, and sometimes, lymph node dissection when required [2425]. However, conservative hormonal therapy can be performed before surgical treatment in young patients diagnosed with clinical stage IA (no evidence of extrauterine spread of disease and myometrial invasion), FIGO grade 1, endometrioid type EM adenocarcinoma who desire to preserve their fertilities [2627].…”

Difference in Practice Patterns in the Management of Endometrial Cancer: A Survey of the Members of 4 East Asian Gynecologic Oncology Groups

“…In addition, we included 108 cases from a study we published in 2015. 8 All data were stored automatically by the Web site SurveyMonkey (http://ko.surveymonkey.com), and all responses were anonymous. The demographic characteristics, including their current practice settings and years since completing fellowship training, were collected.…”

“…All questions were originally developed in English and are described in our previous study. 8 Table 1 shows the demographics of the respondents. Of the 1367 gynecologic oncologists in East Asia who received the survey questionnaire, 376 (27.5%) responded.…”

“…7 In 2015, the Korean Gynecologic Oncology Group (KGOG) conducted a survey to assess surgery and adjuvant therapy practice patterns for endometrial cancer in Korea. 8 The survey showed considerable agreement on modes of surgery, the necessity of lymphadenectomy for surgical staging, and indications for adjuvant therapy. However, treatment preferences for surgery and adjuvant therapy have been found to be influenced by a country's economic status, levels of health care, guidelines, and insurance coverage.…”