Surgical and systemic management of endometrial cancer: an international survey

Christina Fotopoulou, Robert Kraetschell, Sean Dowdy, Keiichi Fujiwara, Nobuo Yaegashi, Domenica Larusso, Antonio Casado, Sven Mahner, Thomas J Herzog, Sean Kehoe, Ignace Vergote, David Scott Miller, Christian Marth, Shingo Fujii, Jalid Sehouli

Research output: Contribution to journalArticlepeer-review

29 Citations (Scopus)


PURPOSE: To ascertain the spectrum of clinical management of endometrial carcinoma (EC) the largest international survey was conducted to evaluate and identify differences worldwide.

METHODS: After validation of a 15-item questionnaire regarding surgical and adjuvant treatment of EC in Germany, an English-adapted questionnaire was put online and posted to all the major gynecological cancer Societies worldwide for further distribution commencing in 2010 and continued for 26 months.

RESULTS: A total of 618 Institutions around the world participated: Central Europe (CE), Southern Europe (SE), Northern Europe (NE), Asia and USA/Canada/UK. Both a therapeutic and staging value was attributed to systematic pelvic and paraaortic lymph node dissection (LND) in CE (74.6 %) and in Asia (67.2 %), as opposed to USA/UK where LND was mainly for staging purposes (53.5 %; p < 0.001). LND was performed up to the renal veins in CE in 86.8 %, in Asia in 80.8 %, in USA/UK in 51.2 % and in SE in 45.1 % (p < 0.001) of cases. In advanced disease, centers from Asia were treated most with adjuvant chemotherapy alone (93.6 %), as opposed to centers in SE, CE and UK/USA that employed combination chemo-radiotherapy in 90.9 % (p < 0.001) of cases. Paclitaxel/carboplatin was mostly used followed by doxorubicin/cisplatin (75 vs. 23.3 %; p < 0.001). In total, 94 % of all participants supported the concept of treating EC patients within appropriate clinical trials.

CONCLUSIONS: There is broad range in both the surgical and adjuvant treatment of EC across different countries. Large-scale multicenter prospective trials are warranted to establish consistent, evidence-based guidelines to optimize treatment worldwide.

Original languageEnglish
Pages (from-to)897-905
JournalArchives of Gynecology and Obstetrics
Issue number4
Early online date15 Oct 2014
Publication statusPublished - Apr 2015


  • Endometrial cancer
  • Survey
  • Lymph node dissection
  • Toxicity
  • Chemotherapy

ASJC Scopus subject areas

  • Medicine(all)


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