AN ANALYSIS OF APPROACHES TO THE TREATMENT OF ENDOMETRIAL CANCER IN WESTERN-EUROPE - A CTF STUDY

The role of this research is to define the clinical-therapeutic approa ch to endometrial cancer currently being followed in some of the most important centres of reference for gynaecological cancer in Western Eu rope. Data was collected by means of a questionnaire, concerning speci fic diagnostic and therapeutic options, sent to 115 leading centres fo r gynaecological oncology in Western Europe, and 82 responses were rec eived. The analysis of the management of this neoplasia in Western Eur opean countries shows significant differences regarding some particula r clinical conditions. Only 24.4% of the interviewed centres stated th at they perform lymphadenectomy routinely, whereas it is most commonly reserved for specific pathological conditions. The presence of lymph node spread is generally considered to be the most important prognosti c element, and currently, radiotherapy of the pelvis appears to be the treatment of choice either as the sole postsurgical therapy (57%) or in combination with systemic treatment. An adjuvant treatment in stage I lymph node-negative patients is adopted in the large majority of th e centres (70.5%) when poorly differentiated cancer (46%) and/or deep myometrial invasion (33.3%) are present. In this condition, radiothera py appears to be the therapy of choice. Histotype and grading are gene rally recognised as important risk factors and result in treatment mod ification; the high percentage of primary surgical modifications is co nsiderable (63.4%) in stage I grade 3 cancers that primarily require l ymphadenectomy or recourse to radical hysterectomy. The results of our study indicate that there is no leading therapy in the advanced stage s of endometrial cancers, but each therapeutic modality is adopted to more or less the same extent.