Should Endometrial Cancer Treatment Be Centralized?

被引:8
作者
Mandato, Vincenzo Dario [1 ]
Palicelli, Andrea [2 ]
Torricelli, Federica [3 ]
Mastrofilippo, Valentina [1 ]
Leone, Chiara [1 ]
Dicarlo, Vittoria [1 ]
Tafuni, Alessandro [2 ,4 ]
Santandrea, Giacomo [2 ,5 ]
Annunziata, Gianluca [1 ]
Generali, Matteo [1 ]
Pirillo, Debora [1 ]
Ciarlini, Gino [6 ]
Aguzzoli, Lorenzo [6 ]
机构
[1] Azienda USL IRCCS Reggio Emilia, Unit Obstet & Gynecol, I-42122 Reggio Emilia, Italy
[2] Azienda USL IRCCS Reggio Emilia, Pathol Unit, I-42122 Reggio Emilia, Italy
[3] Azienda USL IRCCS Reggio Emilia, Lab Translat Res, I-42122 Reggio Emilia, Italy
[4] Univ Parma, Dept Med & Surg, Pathol Unit, I-43121 Parma, Italy
[5] Univ Modena & Reggio Emilia, Clin & Expt Med PhD Program, I-41121 Modena, Italy
[6] Azienda USL IRCCS Reggio Emilia, Unit Surg Gynecol Oncol, I-42122 Reggio Emilia, Italy
来源
BIOLOGY-BASEL | 2022年 / 11卷 / 05期
关键词
endometrial cancer; gynecologic oncologists; general gynecologists; centralization; lymphadenectomy; sentinel lymph node biopsy; frozen section; laparoscopy; high volume centers; tumor board; FERTILITY-SPARING-MANAGEMENT; TRANSVAGINAL ULTRASOUND; PREOPERATIVE ASSESSMENT; ATYPICAL HYPERPLASIA; MYOMETRIAL INVASION; PROGESTIN THERAPY; SURGICAL VOLUME; FOLLOW-UP; OUTCOMES; WOMEN;
D O I
10.3390/biology11050768
中图分类号
Q [生物科学];
学科分类号
07 ; 0710 ; 09 ;
摘要
Simple Summary Endometrial cancer (EC) is the most frequent cancer of the female genital tract in Western and emerging countries. It is commonly thought to be easy to treat as it is usually diagnosed at an early stage, and hysterectomy with bilateral adnexectomy alone is the only treatment required. The progressive replacement of systematic lymphadenectomy with sentinel lymph node biopsy has also fostered this erroneous belief. In fact, if mistreated, EC has a high lethality due to its poor response to chemotherapy in the cases of advanced stage and recurrence. In this paper we reviewed the literature to understand whether the treatment of EC should be reserved for gynecologic oncologists and whether treatment of EC patients should be centralized in high-volume hospitals. We also evaluated the contribution of other specialists involved in the diagnostic and therapeutic pathways of EC. Finally, we suggest a possible network to treat EC patients to ensure effective staging and treatment. Endometrial cancer (EC) is the most common malignancy of the female genital tract in Western and emerging countries. In 2012, new cancer cases numbered 319,605, and 76,160 cancer deaths were diagnosed worldwide. ECs are usually diagnosed after menopause; 70% of ECs are diagnosed at an early stage with a favorable prognosis and a 5-year overall survival rate of 77%. On the contrary, women with advanced or recurrent disease have extremely poor outcomes because they show a low response rate to conventional chemotherapy. EC is generally considered easy to treat, although it presents a 5-year mortality of 25%. Though the guidelines (GLs) recommend treatment in specialized centers by physicians specializing in gynecologic oncology, most women are managed by general gynecologists, resulting in differences and discrepancies in clinical management. In this paper we reviewed the literature with the aim of highlighting where the treatment of EC patients requires gynecologic oncologists, as suggested by the GLs. Moreover, we sought to identify the causes of the lack of GL adherence, suggesting useful changes to ensure adequate treatment for all EC patients.
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页数:18
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