A questionnaire survey on current surgical procedures for endometrial cancer in Japan

The current standards for surgical procedures and lymph node dissection of endometrial cancer in Japan were investigated using a questionnaire survey. The estimated clinical stages used in the questionnaire were predicted fro m preoperative diagnostic imaging, histopathology of endometrial biopsies a nd intraoperative findings using a new classification, Federation Internati onale de Gynecologie et d'Obstetrique (FIGO) in 1988. Questionnaires were m ailed to 235 institutions, and 212 institutions (90.2%) responded. As a sta ndard surgery for endometrial cancer! institutions performed simple total h ysterectomy or semiradical hysterectomy and bilateral adnexectomy, which ac counted for 86%, of all respondents. For stage I carcinoma, simple (44%) or semi-radical (47%) hysterectomy was carried out in 91% of institutions, wh ile radical hysterectomy was selected in 84%, of institutions when stage II carcinoma was diagnosed clinically. The consensus of this survey was that dissection of both the para-aortic and pelvic lymph nodes can be omitted in G1 cases showing lesions confined to the endometrium, and that pelvic lymp h nodes should be dissected, but para-aortic lymph node dissection could be omitted in G1 or G2 cases demonstrating myometrial invasion of 1/2 or less . Moreover, findings from this survey suggest that biopsy or dissection of the para-aortic lymph nodes was required in G3 cases, or in those patients diagnosed with myometrial invasion more than 1/2.