[Non endometroid endometrial cancer guidelines evaluation: A multicentric retrospective study]

Area of Science:

• Gynecologic Oncology
• Clinical Guidelines
• Cancer Management

Background:

• Non-endometrioid endometrial cancers are rare and associated with poor prognoses.
• Effective management strategies are crucial for improving outcomes in these infrequent malignancies.

Purpose of the Study:

• To evaluate the application of current endometrial cancer guidelines for non-endometrioid subtypes.
• To identify barriers to guideline adherence in the management of these rare cancers.

Main Methods:

• A multicentric retrospective study involving 74 cases of non-endometrioid endometrial cancer from January 2009 to December 2019.
• Analysis of management decisions in relation to French national guidelines applicable at the time of treatment.
• Specific focus on initial and adjuvant treatment phases, noting reasons for guideline non-application.

Main Results:

• The cohort comprised 34 carcinosarcomas, 29 serous carcinomas, 9 clear cell carcinomas, and 2 undifferentiated carcinomas.
• Guidelines were applied in 45.9% of initial management cases, with lack of surgical lymph node staging being the primary reason for non-application (57.1%).
• Guidelines were applied in 38.7% of adjuvant management cases, with incomplete lymph node staging being the main reason for non-application (67.6%).

Conclusions:

• Applicability of current guidelines for non-endometrioid endometrial cancer is challenging, often due to patient comorbidities and the necessity of surgical lymph node staging.
• The study highlights difficulties in achieving complete staging, impacting treatment decisions.
• Adoption of novel staging techniques may enable more targeted management and better selection of lymph node staging indications.