Primer consenso Mexicano de cáncer de endometrio: Grupo de Investigación en Cáncer de Ovario y Tumores Ginecológicos de México "GICOM"

Translated title of the contribution: The first Mexican consensus of endometrial cancer

Eva Ruvalcaba-Limón, David Cantú-de-León, Eucario León-Rodríguez, Patricia Cortés-Esteban, Alberto Serrano-Olvera, Flavia Morales-Vásquez, Ricardo Sosa-Sánchez, Andrés Poveda-Velasco, Alejandro Crismatt-Zapata, Antonio Santillán-Gómez, Carmen Aguilar-Jiménez, Patricia Alanís-López, Paulino Alfaro-Ramírez, Miguel Ángel Álvarez-Avitia, Carlos Eduardo Aranda-Flores, José Héctor Reynaldo Arias-Ceballos, Oscar Arrieta-Rodríguez, Eduardo Barragán-Curiel, Daniel Botello-Hernández, Rocío Brom-ValladaresPaula Anel Cabrera-Galeana, Juan Carlos Cantón-Romero, Daniel Capdeville-García, Jesús Cárdenas-Sánchez, Gerardo Castorena-Roji, Friedman Rafael Cepeda-López, Guadalupe Cervantes-Sánchez, Lucely Del Carmen Cetina-Pérez, Jaime Alberto Coronel-Martínez, Seir Alfonso Cortés-Cárdenas, Juan Carlos Cruz-López, Jaime G. De La Garza-Salazar, Consuelo Díaz-Romero, Alfonso Dueñas-González, Aura Erazo Valle-Solís, Pedro Escudero-de Los Ríos, Efrén Flores-Álvarez, Rolando García-Matus, Raquel Gerson-Cwilich, Aarón González-Enciso, César González-de-León, Alfonso Genaro Guevara-Torres, Guillermo Sidney Herbert-Núñez, Carlos Hernández-Hernández, Dulce María Hernández-Hernández, David Isla-Ortiz, Ramiro Jesús-Sandoval, Carlos Jiménez-Cervantes, Roberto Kuri-Exsome, José Luis López-Obispo, Antonio Maffuz-Aziz, Luis Manuel Martínez-Barrera, Juan Manuel Medina-Castro, Gonzalo Montalvo-Esquivel, Victor Hugo Mora-Aguilar, Miguel Ángel Morales-Palomares, Andrés Morán-Mendoza, Gilberte Morgan-Villela, Aída Mota-García, David Eduardo Muñoz-González, Dino Alberto Murillo-Cruz, Arturo Novoa-Vargas, Francisco J. Ochoa-Carrillo, Luis Fernando Oñate-Ocaña, Andrea Ortega-Rojo, Alma Georgina Palacios-Martínez, Antonio Palomeque-López, Maria Delia Pérez-Montiel, Félix Quijano-Castro, Samuel Rivera-Rivera, Lesbia María Rivera-Rubí, Juan Ubaldo Robles-Flores, Amelia Rodríguez-Trejo, Efraín Salas-Gonzáles, Juan Alejandro Silva, Gilberto Solorza-Luna, Rosalía Souto-del-Bosque, Laura Leticia Tirado-Gómez, Salvador Torrescano-González, Alfonso Torres-Lobatón, Elizabeth Trejo-Durán, Verónica Villavicencio-Valencia, Dolores Gallardo-Rincón

Research output: Contribution to journalArticlepeer-review

Abstract

Introduction. Endometrial cancer (EC) is the second most common gynecologic malignancy worldwide in the peri and postmenopausal period. Most often for the endometrioid variety. In early clinical stages long-term survival is greater than 80%, while in advanced stages it is less than 50%. In our country there is not a standard management between institutions. GICOM collaborative group under the auspice of different institutions have made the following consensus in order to make recommendations for the management of patients with this type of neoplasm. Material and methods. The following recommendations were made by independent professionals in the field of Gynecologic Oncology, questions and statements were based on a comprehensive and systematic review of literature. It took place in the context of a meeting of four days in which a debate was held. These statements are the conclusions reached by agreement of the participant members. Results. Screening should be performed women at high risk (diabetics, family history of inherited colon cancer, Lynch S. type II). Endometrial thickness in postmenopausal patients is best evaluated by transvaginal US, a thickness greater than or equal to 5 mm must be evaluated. Women taking tamoxifen should be monitored using this method. Abnormal bleeding in the usual main symptom, all post menopausal women with vaginal bleeding should be evaluated. Diagnosis is made by histerescopy-guided biopsy. Magnetic resonance is the best image method as preoperative evaluation. Frozen section evaluates histologic grade, myometrial invasion, cervical and adnexal involvement. Total abdominal hysterectomy, bilateral salpingo oophorectomy, pelvic and para-aortic lymphadenectomy should be performed except in endometrial histology grades 1 and 2, less than 50% invasion of the myometrium without evidence of disease out of the uterus. Omentectomy should be done in histologies other than endometriod. Surgery should be always performed by a Gynecologic Oncologist or Surgical Oncologist, laparoscopy is an alternative, especially in patients with hypertension and diabetes for being less morbid. Adjuvant treatment after surgery includes radiation therapy to the pelvis, brachytherapy, and chemotherapy. Patients with Stages III and TV should have surgery with intention to achieve optimal cytoreduction because of the impact on survival (51 m vs. 14 m), the treatment of recurrence can be with surgery depending on the pattern of relapse, systemic chemotherapy or hormonal therapy. Follow-up of patients is basically clinical in a regular basis. Conclusions. Screening programme is only for high risk patients. Multidisciplinary treatment impacts on survival and local control of the disease, including surgery, radiation therapy and chemotherapy, hormonal treatment is reserved to selected cases of recurrence. This is the first attempt of a Mexican Collaborative Group in Gynecology to give recommendations is a special type of neoplasm.

Translated title of the contributionThe first Mexican consensus of endometrial cancer
Original languageSpanish
Pages (from-to)585-605
Number of pages21
JournalRevista de Investigacion Clinica
Volume62
Issue number6
StatePublished - Nov 2010

Keywords

  • Cancer
  • Chemotherapy
  • Endometrial
  • Hormone therapy
  • Radiotherapy
  • Surgery

ASJC Scopus subject areas

  • Medicine(all)

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