Optimal tactics of adjuvant treatment of patients with endometrial cancer


Citar

Texto integral

Acesso aberto Acesso aberto
Acesso é fechado Acesso está concedido
Acesso é fechado Acesso é pago ou somente para assinantes

Resumo

Endometrial cancer is the most common gynecological tumor in developed countries, and its incidence is growing. The most common histological subtype is the endometrioid adenocarcinoma. The disease is often diagnosed when the tumor is still limited to the uterus. The standard treatment includes primary extirpation of the uterus with appendages, often using minimally invasive methods (laparoscopic). The surgical strategy for the removal of lymph nodes depends on a number of factors: the histological variant of the tumor (subtype, malignancy, involvement of the lymphovascular space), the stage of the disease (including invasion of the myometrium), the characteristics of patients (age and concomitant diseases), national and international recommendations. The choice of the best adjuvant treatment is carried out in accordance with the histological type and stage of the disease. Different classifications are used to assess the risk of relapse and determine the optimal post-operative treatment. The overall 5-year survival of patients with early stages of endometrial cancer ranges from 74 to 91%. High-risk group is the most uncertain group of patients with regard to the choice of optimal adjuvant treatment, and research with the inclusion of chemotherapy, as well as chemoradiotherapy, in relation to this group of patients is still under way. The purpose of these studies is to determine the best balance between survival and quality of life of patients.

Texto integral

Acesso é fechado

Sobre autores

S. Khokhlova

FSBI «RORC n.a. N.N. Blokhin» of RMH

Email: svkhokhlova@mail.ru
MD, Senior Researcher at the Department of Chemotherapy

I. Bazaeva

FSBI «RORC n.a. N.N. Blokhin» of RMH

Bibliografia

  1. Ferlay J., Soerjomataram I., Dikshit R., Eser S., Mathers C., Rebelo M., Parkin D.M., Forman D., Bray F. Cancer incidence and mortality worldwide: sources, methods and major patterns in GLOBOCAN 2012. Int. J. Cancer. 2015;136:E359-86.
  2. National Cancer Institute. Previous version: SEER Cancer Statistics Review, 1975-2012, Na- tional Cancer Institute. Available at http://seer. cancer. gov/csr/1975_2012/. Accessed October 5, 2016.
  3. Hamilton C.A., Cheung M.K., Osann K., Chen L., Teng N.N., Longacre T.A., Powell M.A., Hendrickson M.R., Kapp D.S., Chan J.K. Uterine papillary serous and clear cell carcinomas predict for poorer survival compared to grade 3 endometrioid corpus cancers. Br. J. Cancer. 2006;94:642-46.
  4. National Comprehensive Cancer Network. Uterine neoplasms. Available at http://www.nccn. org/ professionals/physician_gls/pdf/uterine. pdf. Accessed November 1, 2016.
  5. Benedetti Panici P., Basile S., Maneschi F., Alberto Lissoni A., Signorelli M., Scambia G., et al. Systematic pelvic lymphadenectomy vs. no lympha- denectomy in early-stage endometrial carcinoma: Randomized clinical trial. J. Natl. Cancer Inst. 2008;100:1707-16.
  6. Creutzberg C.L., van Putten W.L., Koper P.C., Lybeert M.L.JobsenJ.J, Wârlâm-RodenhuisC.C., De Winter K.A, Lutgens L.C., van den Bergh A.C., van de Steen-Banasik E., Beerman H., van Lent M. Surgery and postoperative radiotherapy versus surgery alone for patients with stage 1 endometrial carcinoma: multicentre randomised trial. PORTEC Study Group. Post Operative Radiation Therapy in Endometrial Carcinoma. Lancet. 2000;355:1404-11.
  7. Keys H.M., Roberts J.A., Brunetto V.L., Zaino R.J., Spirtos N.M., Bloss J.D., Pearlman A., Maiman M.A., Bell J.G.; the Gynecologic Oncology Group. A phase III trial of surgery with or without adjunctive external pelvic radiation therapy in intermediate risk endometrial adenocarcinoma: a Gynecologic Oncology Group study. Gynecol. Oncol. 2004;92:744-51.
  8. Todo Y., Kato H., Kaneuchi M., Watari H., Takeda M., Sakuragi N. Survival effect of para-aortic lymphadenectomy in endometrial cancer (SEPAL study): a retrospective cohort analysis. Lancet. 2010;375:1165-72.
  9. Bendifallah S., Canlorbe G., Raimond E., Hudry D., Coutant C., Graesslin O., Touboul C., Huguet F., Cortez A., Darai' E., Ballester M. A clue towards improving the European Society of Medical Oncology risk group classification in apparent early stage endometrial cancer? Impact of lymphovascular space invasion. Br. J. Cancer. 2014;110:2640-46.
  10. Querleu D., Planchamp F., Narducci F., Morice P., Joly F., Genestie C., Haie-Meder C., Thomas L., Quénel-Tueux N., Darai E., Dorangeon P.H., Marret H., Taieb S., Mazeau-Woynar V; the Institut National du Cancer; the Societe Francaise d'Oncologie Gynecologique. Clinical practice guidelines for the management of patients with endometrial cancer in France: recommendations of the Institut National du Cancer and the Société Française d'Oncologie Gynécologique. Int. J. Gynecol. Cancer. 2011;21:945-50.
  11. SGO Clinical Practice Endometrial Cancer Working Group., Burke W.M., Orr J., Leitao M., Salom E., Gehrig P., Olawaiye A.B., Brewer M., Boruta D., Villella J., Herzog T., Abu Shahin F.; Society of Gynecologic Oncology Clinical Practice Committee. Endometrial cancer: a review and current management strategies: part I. Gynecol. Oncol. 2014;134:385-92.
  12. SGO Clinical Practice Endometrial Cancer Working Group., Burke W.M., Orr J., Leitao M., Salom E., Gehrig P., Olawaiye A.B., Brewer M., Boruta D., Herzog T., Shahin F.A.; Society of Gynecologic Oncology Clinical Practice Committee. Endometrial cancer: a review and current management strategies: part II. Gynecol. Oncol. 2014;134:393-402.
  13. Mariani A., Dowdy S.C., Cliby W.A., Gostout B.S., Jones M.B., Wilson T.O., Podratz K.C. Prospective assessment of lymphatic dissemination in endometrial cancer: a paradigm shift in surgical staging. Gynecol. Oncol. 2008; 109:11-8.
  14. Beesley V.L., Rowlands I.J., Hayes S.C., Janda M., O'Rourke P., Marquart L., Quinn M.A., Spurdle A.B., Obermair A., Brand A., Oehler M.K., Leung Y., McQuire L., Webb PM.; Australian National Endometrial Cancer Study Group. Incidence, risk factors and estimates of a woman's risk of developing secondary lower limb lymphedema and lymphedema-specific supportive care needs in women treated for endometrial cancer. Gynecol. Oncol. 2015; 136:87-93.
  15. Kilgore L.C., Partridge E.E., Alvarez R.D., Austin J.M., Shingleton H.M., Noojin F. 3rd, Conner W. Adenocarcinoma of the endometrium: survival comparisons of patients with and without pelvic node sampling. Gynecol. Oncol. 1995; 56:29-33.
  16. Kitchener H., Swart A.M., Qian Q., Amos C., Parmar M.K.; the ASTEC study group. Efficacy of systematic pelvic lymphadenectomy in endometrial cancer (MRC ASTEC trial): a randomised study. Lancet. 2009;373:125-36.
  17. Janda M., Gebski V., Brand A., Hogg R., Jobling T.W, Land R., et al. Quality of life after total laparoscopic hysterectomy versus total abdominal hysterectomy for stage I endometrial cancer (LACE): a randomised trial. Lancet Oncol. 2010;11:772-80.
  18. Aalders J., Abeler V., Kolstad P, Onsrud M. Postoperative external irradiation and prognostic parameters in stage I endometrial carcinoma: clinical and histopathologic study of 540 patients. Obstet. Gynecol. 1980;56:419-27.
  19. Onsrud M., Cvancarova M., Hellebust T.P., Tropé C.G., Kristensen G.B., Lindemann K. Long-term outcomes after pelvic radiation for early-stage endometrial cancer. J. Clin. Oncol. 2013;31:3951-56.
  20. Creutzberg C.L., Nout R.A., Lybeert M.L., Wárlám-Rodenhuis C.C., Jobsen J.J., Mens J.W., Lutgens L.C., Pras E., van de Poll-Franse L.V., van Putten W.L.; PORTEC Study Group. Fifteen-year radiotherapy outcomes of the randomized PORTEC-1 trial for endometrial carcinoma. Int. J. Radiat. Oncol. Biol. Phys. 2011;81:e631-38.
  21. ASTEC/EN.5 Study Group., Blake P., Swart A.M., Orton J., Kitchener H., Whelan T., Lukka H., Eisenhauer E., Bacon M., Tu D., Parmar M.K., Amos C., Murray C., Qian W. Adjuvant external beam radiotherapy in the treatment of endometrial cancer (MRC ASTEC and NCIC CTG EN.5 randomised trials): pooled trial results, systematic review, and meta-analysis. Lancet. 2009;373:137-46.
  22. Nout R.A., Smit V.T., Putter H., Jürgenliemk-Schulz I.M., Jobsen J.J., Lutgens L.C., van der Steen-Banasik E.M., Mens J.W., Slot A., Kroese M.C., van Bunningen B.N., Ansink A.C., van Putten W.L., Creutzberg C.L.; PORTEC Study Group. Vaginal brachytherapy versus pelvic external beam radiotherapy for patients with endometrial cancer of high-intermediate risk (PORTEC-2): an open-label, non-inferiority, randomised trial. Lancet. 2010;375:816-23.
  23. Sorbe B., Horvath G., Andersson H., Boman K., Lundgren C., Pettersson B. External pelvic and vaginal irradiation versus vaginal irradiation alone as postoperative therapy in mediumrisk endometrial carcinoma-a prospective randomized study. Int. J. Radiat. Oncol. Biol. Phys. 2012;82:1249-55.
  24. Kong A., Johnson N., Kitchener H.C., Lawrie T.A. Adjuvant radiotherapy for stage I endometrial cancer: an updated Cochrane systematic review and meta-analysis. J. Natl. Cancer Inst. 2012;104:1625-34.
  25. Kunneman M., Pieterse A.H., Stiggelbout A.M., Nout R.A., Kamps M., Lutgens L.C., Paulissen J., Mattheussens O.J., Kruitwagen R.F., Creutzberg C.L. Treatment preferences and involvement in treatment decision making of patients with endometrial cancer and clinicians. Br. J. Cancer. 2014;111:674-79.
  26. Susumu N., Sagae S., Udagawa Y., Niwa K., Kuramoto H., Satoh S., Kudo R.; Japanese Gynecologic Oncology Group. Randomized phase III trial of pelvic radiotherapy versus cisplatin-based combined chemotherapy in patients with intermediate- and high-risk endometrial cancer: a Japanese Gynecologic Oncology Group study. Gynecol. Oncol. 2008;108:226-33.
  27. Maggi R., Lissoni A., Spina F., Melpignano M., Zola P., Favalli G., Colombo A., Fossati R. Adjuvant chemotherapy vs radiotherapy in high-risk endometrial carcinoma: results of a randomised trial. Br. J. Cancer. 2006;95:266-71.
  28. Randall M.E., Filiaci V.L., Muss H., Spirtos N.M., Mannel R.S., Fowler J., Thigpen J.T., Benda J.A.; а Gynecologic Oncology Group study. Randomized phase III trial of whole-abdominal irradiation versus doxorubicin and cisplatin chemotherapy in advanced endometrial carcinoma: a Gynecologic Oncology Group study. J. Clin. Oncol. 2006;24:36-44.
  29. Morrow C.P., Bundy B.N., Homesley H.D., Creasman W.T., Hornback N.B., Kurman R., Thigpen J.T. Doxorubicin as an adjuvant following surgery and radiation therapy in patients with high-risk endometrial carcinoma, stage I and occult stage II: a Gynecologic Oncology Group Study. Gynecol. Oncol. 1990;36:166-71.
  30. Kuoppala T., Mäenpää J., Tomas E., Puistola U., Salmi T., Grenman S., Lehtovirta P., Fors M., Luukkaala T., Sipilä P. Surgically staged high-risk endometrial cancer: randomized study of adjuvant radiotherapy alone vs sequential chemo-radiotherapy. Gynecol. Oncol. 2008;110:190-95.
  31. Hogberg T., Signorelli M., deOliveira C.F., Fossati R., Lissoni A.A., Sorbe B., et al. Sequential adjuvant chemotherapy and radiotherapy in endometrial cancer-results from two randomised studies. Eur. J. Cancer. 2010;46:2422-31.
  32. Miller D., Filiaci V., Fleming G., et al. Randomized phase III noninferiority trial of first line chemotherapy for metastatic or recurrent endometrial carcinoma: A Gynecologic Oncology Group study. Gynecol. Oncol.2012;125:771.
  33. McMeekin D.S., Aghajanian C., Cho J., et al. Randomized phase III trial of pelvic radiation therapy (PXRT) versus vaginal cuff brachytherapy followed by paclitaxel/carboplatin chemotherapy (VCB/C) in patients with high risk (HR), early stage endometrial cancer (EC): A Gynecologic Oncology Group trial. Gynecol. Oncol. 2016;134:438.
  34. Cancer Genome Atlas Research Network, Kandoth C., Schultz N., Cherniack A.D., Akbani R., Liu Y., Shen H., Robertson A.G., Pashtan I., Shen R., Benz C.C., Yau C., Laird P.W., Ding L., Zhang W., Mills G.B., Kucherlapati R., Mardis E.R., Levine D.A. Integrated genomic characterization of endometrial carcinoma. Nature. 2013;497:67-73.
  35. McConechy M.K., Talhouk A., Leung S., Chiu D., Yang W., Senz J., Reha-Krantz L.J., Lae C.H., Huntsman D.G., Gilks C.B., McAlpine J.N. Endometrial carcinomas with POLE exonuclease domain mutations have a favorable prognosis. Clin. Cancer. Res. 2016;22:2865-73.
  36. McMeekin D.S., Filiaci V.L., Thigpen J.T. Gallion H.H., Fleming G.F., Rodgers W.H.; Gynecologic Oncology Group study. The relationship between histology and outcome in advanced and recurrent endometrial cancer patients participating in first-line chemotherapy trials: A Gynecologic Oncology Group study. Gynecol. Oncol. 2007;106:16-22.

Arquivos suplementares

Arquivos suplementares
Ação
1. JATS XML
Baixar

Declaração de direitos autorais © Bionika Media, 2017

Este site utiliza cookies

Ao continuar usando nosso site, você concorda com o procedimento de cookies que mantêm o site funcionando normalmente.

Informação sobre cookies