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Facts, views & vision in ObGyn
03, 2023;15 (1): 3-23.

ESGO/ESHRE/ESGE Guidelines for the fertility-sparing treatment of patients with endometrial carcinoma.

A Rodolakis, G Scambia, F Planchamp, M Acien, A Di Spiezio Sardo, M Farrugia, M Grynberg, M Paki��, K Pavlakis, N Vermeulen, G Zannoni, I Zapardiel, K L Tryde Macklon
Author Information
PMID: 37010330 DOI: 10.52054/FVVO.15.1.065

Abstract

Background: The standard surgical treatment of endometrial carcinoma (EC) consisting of total hysterectomy with bilateral salpingo-oophorectomy drastically affects the quality of life of patients and creates a challenge for clinicians. Recent evidence-based guidelines of the European Society of Gynaecological Oncology (ESGO), the European SocieTy for Radiotherapy & Oncology (ESTRO) and the European Society of Pathology (ESP) provide comprehensive guidelines on all relevant issues of diagnosis and treatment in EC in a multidisciplinary setting. While also addressing work-up for fertility preservation treatments and the management and follow-up for fertility preservation, it was considered relevant to further extend the guidance on fertility sparing treatment.
Objectives: To define recommendations for fertility-sparing treatment of patients with endometrial carcinoma.
Materials and Methods: ESGO/ESHRE/ESGE nominated an international multidisciplinary development group consisting of practicing clinicians and researchers who have demonstrated leadership and expertise in the care and research of EC (11 experts across Europe). To ensure that the guidelines are evidence-based, the literature published since 2016, identified from a systematic search was reviewed and critically appraised. In the absence of any clear scientific evidence, judgment was based on the professional experience and consensus of the development group. The guidelines are thus based on the best available evidence and expert agreement. Prior to publication, the guidelines were reviewed by 95 independent international practitioners in cancer care delivery and patient representatives.
Results: The multidisciplinary development group formulated 48 recommendations for fertility-sparing treatment of patients with endometrial carcinoma in four sections: patient selection, tumour clinicopathological characteristics, treatment and special issues.
Conclusions: These recommendations provide guidance to professionals caring for women with endometrial carcinoma, including but not limited to professionals in the field of gynaecological oncology, onco-fertility, reproductive surgery, endoscopy, conservative surgery, and histopathology, and will help towards a holistic and multidisciplinary approach for this challenging clinical scenario.
What is new?: A collaboration was set up between the ESGO, ESHRE and ESGE, aiming to develop clinically relevant and evidence-based guidelines focusing on key aspects of fertility-sparing treatment in order to improve the quality of care for women with endometrial carcinoma across Europe and worldwide.

References

  1. Virchows Arch. 2021 Feb;478(2):153-190 [PMID: 33604759]
  2. BBA Clin. 2014 Jul 25;2:7-9 [PMID: 26674650]
  3. Am J Surg Pathol. 1999 Sep;23(9):1102-8 [PMID: 10478671]
  4. Int J Clin Oncol. 2019 Jun;24(6):712-720 [PMID: 30746595]
  5. Eur J Obstet Gynecol Reprod Biol. 2019 Sep;240:220-225 [PMID: 31326637]
  6. Front Oncol. 2019 May 07;9:359 [PMID: 31134155]
  7. J Obstet Gynaecol Res. 2021 Mar;47(3):984-991 [PMID: 33403812]
  8. J Clin Med. 2021 Dec 29;11(1): [PMID: 35011924]
  9. J Minim Invasive Gynecol. 2021 Mar;28(3):392-402 [PMID: 33373729]
  10. Cancer Manag Res. 2019 May 06;11:4005-4021 [PMID: 31190979]
  11. J Res Med Sci. 2021 Jul 31;26:48 [PMID: 34484380]
  12. Lancet. 2003 May 24;361(9371):1810-2 [PMID: 12781553]
  13. J Cancer. 2021 Jan 1;12(3):754-764 [PMID: 33403033]
  14. J Clin Oncol. 2007 Jul 1;25(19):2798-803 [PMID: 17602085]
  15. Int J Gynecol Cancer. 2018 Sep;28(7):1258-1263 [PMID: 29994910]
  16. Cancer. 2017 Mar 1;123(5):802-813 [PMID: 28061006]
  17. Front Oncol. 2020 Aug 25;10:1437 [PMID: 32983972]
  18. Int J Gynecol Cancer. 2020 May;30(5):640-647 [PMID: 32169874]
  19. Cancers (Basel). 2021 Jun 07;13(11): [PMID: 34200374]
  20. Am J Surg Pathol. 1998 Aug;22(8):1012-9 [PMID: 9706982]
  21. Minerva Med. 2021 Feb;112(1):55-69 [PMID: 33205638]
  22. Cancer Res. 2014 May 15;74(10):2796-802 [PMID: 24662919]
  23. Int J Gynecol Cancer. 2017 Mar;27(3):473-478 [PMID: 28187097]
  24. Int J Radiat Oncol Biol Phys. 2021 Feb 1;109(2):396-412 [PMID: 32942005]
  25. J Coll Physicians Surg Pak. 2018 Apr;28(4):262-265 [PMID: 29615163]
  26. Med Ultrason. 2022 Feb 16;24(1):77-84 [PMID: 33793698]
  27. Gynecol Oncol. 1990 Jul;38(1):59-65 [PMID: 2141316]
  28. Cancer Manag Res. 2021 Jul 14;13:5711-5722 [PMID: 34285588]
  29. Cancer Prev Res (Phila). 2021 Nov;14(11):1041-1050 [PMID: 34348914]
  30. Gynecol Oncol. 2021 Jun;161(3):810-816 [PMID: 33875233]
  31. Eur J Obstet Gynecol Reprod Biol. 2022 Apr;271:117-127 [PMID: 35183001]
  32. Lancet. 2016 Mar 12;387(10023):1094-1108 [PMID: 26354523]
  33. Int J Gynecol Cancer. 2018 Feb;28(2):385-393 [PMID: 29266019]
  34. Obstet Gynecol Sci. 2020 Jul;63(4):417-431 [PMID: 32689770]
  35. Obstet Gynecol. 2010 Jul;116(1):168-176 [PMID: 20567184]
  36. Eur J Obstet Gynecol Reprod Biol. 2021 Feb;257:121-126 [PMID: 33383411]
  37. Genet Med. 2020 Jan;22(1):15-25 [PMID: 31337882]
  38. Asian Pac J Cancer Prev. ;18(11):3111-3116 [PMID: 29172287]
  39. J Pathol Clin Res. 2017 Oct 14;3(4):279-293 [PMID: 29085668]
  40. J Pathol. 2020 Mar;250(3):312-322 [PMID: 31829447]
  41. Int J Gynaecol Obstet. 2016 Jan;132(1):34-8 [PMID: 26493012]
  42. Int J Gynecol Cancer. 2021 Mar;31(3):332-338 [PMID: 33649002]
  43. Acta Obstet Gynecol Scand. 2021 Aug;100(8):1526-1533 [PMID: 33721324]
  44. Onco Targets Ther. 2017 Dec 15;10:5937-5943 [PMID: 29290687]
  45. Eur J Obstet Gynecol Reprod Biol. 2021 Aug;263:139-147 [PMID: 34214800]
  46. Front Med (Lausanne). 2018 Aug 27;5:240 [PMID: 30211167]
  47. Int J Gynecol Pathol. 2021 Sep 1;40(5):495-500 [PMID: 32897954]
  48. J Comput Assist Tomogr. 1995 Sep-Oct;19(5):766-72 [PMID: 7560323]
  49. J Minim Invasive Gynecol. 2019 May - Jun;26(4):648-656 [PMID: 30017893]
  50. Eur J Obstet Gynecol Reprod Biol. 2017 Jun;213:71-97 [PMID: 28437632]
  51. Ecancermedicalscience. 2019 Jan 16;13:892 [PMID: 30792809]
  52. Radiology. 2004 May;231(2):372-8 [PMID: 15031434]
  53. Oncotarget. 2017 May 3;8(34):57642-57653 [PMID: 28915701]
  54. Fertil Steril. 2014 Mar;101(3):785-94 [PMID: 24388202]
  55. CA Cancer J Clin. 2021 May;71(3):209-249 [PMID: 33538338]
  56. Int J Gynecol Cancer. 2021 Mar;31(3):345-351 [PMID: 32565487]
  57. Cancer. 2006 Feb 15;106(4):812-9 [PMID: 16400639]
  58. J Minim Invasive Gynecol. 2021 Sep;28(9):1625-1632 [PMID: 33571678]
  59. Biomed Res Int. 2017;2017:1318203 [PMID: 28812010]
  60. Reprod Biomed Online. 2021 Sep;43(3):495-502 [PMID: 34315696]
  61. J Gynecol Oncol. 2017 Jan;28(1):e2 [PMID: 27670256]
  62. J Gynecol Oncol. 2020 Sep;31(5):e74 [PMID: 32808500]
  63. Med Sci Monit. 2019 Mar 18;25:2024-2031 [PMID: 30883538]
  64. Gynecol Oncol. 2014 Apr;133(1):33-7 [PMID: 24680589]
  65. Int J Gynecol Cancer. 2017 Feb;27(2):289-296 [PMID: 27922981]
  66. Ann Oncol. 2016 Feb;27(2):262-6 [PMID: 26578736]
  67. Int J Gynecol Cancer. 2017 May;27(4):738-742 [PMID: 28346240]
  68. Acta Obstet Gynecol Scand. 2019 Aug;98(8):976-987 [PMID: 30779338]
  69. Gynecol Oncol. 2018 Sep;150(3):426-431 [PMID: 30126589]
  70. Ultrasound Obstet Gynecol. 2015 Oct;46(4):405-13 [PMID: 26011665]
  71. Am J Transl Res. 2021 May 15;13(5):5412-5419 [PMID: 34150138]
  72. Minerva Med. 2021 Feb;112(1):3-11 [PMID: 33205640]
  73. JAMA. 2002 Oct 2;288(13):1610-21 [PMID: 12350192]
  74. Acta Obstet Gynecol Scand. 2019 Sep;98(9):1086-1099 [PMID: 30793281]
  75. Int J Gynecol Cancer. 2020 Nov;30(11):1811-1823 [PMID: 32381512]
  76. Fertil Steril. 2011 Oct;96(4):957-61 [PMID: 21872230]
  77. Int J Cancer. 2019 Feb 1;144(3):641-650 [PMID: 30289975]
  78. Int J Gynecol Cancer. 2016 Jul;26(6):1105-10 [PMID: 27177278]
  79. Cancer Epidemiol Biomarkers Prev. 2017 May;26(5):727-735 [PMID: 28052940]
  80. Gynecol Oncol. 2021 Jun;161(3):802-809 [PMID: 33892887]
  81. Case Rep Womens Health. 2019 Apr 25;22:e00117 [PMID: 31080752]
  82. Magn Reson Imaging. 2019 Apr;57:285-292 [PMID: 30580078]
  83. JAMA Oncol. 2017 Dec 1;3(12):1702-1706 [PMID: 28772289]
  84. J Gynecol Oncol. 2019 Jul;30(4):e62 [PMID: 31074243]
  85. J Pathol Clin Res. 2015 May 27;1(3):186-93 [PMID: 27499903]
  86. Facts Views Vis Obgyn. 2022 Jun;14(2):103-110 [PMID: 35781106]
  87. Int J Obes (Lond). 2022 Mar;46(3):605-612 [PMID: 34857870]
  88. Am J Surg Pathol. 2000 Sep;24(9):1201-8 [PMID: 10976693]
  89. Clin Infect Dis. 2001 Jul 15;33(2):139-44 [PMID: 11418871]
  90. Am J Obstet Gynecol. 2021 Apr;224(4):370.e1-370.e13 [PMID: 33039397]
  91. Acta Obstet Gynecol Scand. 2016 Jan;95(1):55-64 [PMID: 26485119]
  92. Cancers (Basel). 2021 Feb 03;13(4): [PMID: 33546293]
  93. Int J Gynaecol Obstet. 2019 Sep;146(3):277-288 [PMID: 31197826]
  94. BJOG. 2017 Sep;124(10):1576-1583 [PMID: 28128512]
  95. Rev Bras Ginecol Obstet. 2020 Oct;42(10):642-648 [PMID: 33129220]
  96. Reprod Med Biol. 2016 Dec 05;16(1):67-71 [PMID: 29259453]
  97. Int J Gynaecol Obstet. 2018 Oct;143 Suppl 2:37-50 [PMID: 30306580]
  98. Medicine (Baltimore). 2017 Sep;96(37):e8034 [PMID: 28906392]
  99. Indian J Surg Oncol. 2019 Mar;10(1):220-224 [PMID: 30948904]
  100. Int J Womens Health. 2014 Jul 29;6:691-701 [PMID: 25114594]
  101. Ultrasound Obstet Gynecol. 2016 Mar;47(3):369-73 [PMID: 26033260]
  102. J Gynecol Oncol. 2019 Nov;30(6):e90 [PMID: 31576686]
  103. Cancers (Basel). 2021 Mar 19;13(6): [PMID: 33808691]
  104. Int J Gynecol Cancer. 2021 Jun;31(6):944-945 [PMID: 33962995]
  105. J Gynecol Oncol. 2021 Jul;32(4):e57 [PMID: 34085795]
  106. Cancer Lett. 2006 Aug 8;239(2):198-204 [PMID: 16168561]
  107. Cells. 2021 Feb 01;10(2): [PMID: 33535622]
  108. Ann Oncol. 2018 May 1;29(5):1180-1188 [PMID: 29432521]
  109. J Obstet Gynaecol Can. 2018 Mar;40(3):328-333 [PMID: 28986185]
  110. Mol Clin Oncol. 2014 Nov;2(6):909-916 [PMID: 25279173]
  111. Cancers (Basel). 2020 Jan 23;12(2): [PMID: 31979212]
  112. Clin Cancer Res. 2016 Aug 15;22(16):4215-24 [PMID: 27006490]
  113. Gynecol Oncol. 2019 Jun;153(3):487-495 [PMID: 30922603]
  114. J Obstet Gynaecol Can. 2019 Dec;41(12):1789-1800 [PMID: 31785798]
  115. Histopathology. 2014 Jan;64(2):284-92 [PMID: 24111732]
  116. Gynecol Oncol. 2008 Dec;111(3):579-82 [PMID: 18395778]
  117. Med Ultrason. 2018 Aug 30;20(3):348-354 [PMID: 30167589]
  118. Int J Gynecol Cancer. 2021 Jan;31(1):12-39 [PMID: 33397713]
  119. Ultrasound Obstet Gynecol. 2021 Sep;58(3):469-475 [PMID: 33533532]
  120. Int J Gynecol Cancer. 2017 Jan;27(1):77-84 [PMID: 27922977]
  121. Acad Radiol. 2020 Jul;27(7):960-968 [PMID: 31636004]
  122. J Ultrasound Med. 2022 Feb;41(2):335-342 [PMID: 33780025]
  123. Reprod Biol Endocrinol. 2021 Aug 3;19(1):118 [PMID: 34344384]
  124. Int J Gynecol Cancer. 2016 Jul;26(6):1081-91 [PMID: 27177279]
  125. Mod Pathol. 2017 Jul;30(7):1032-1041 [PMID: 28281553]
  126. Radiologia (Engl Ed). 2019 Jul - Aug;61(4):315-323 [PMID: 30905489]
  127. Hum Reprod Update. 2016 Apr;22(3):281-305 [PMID: 26759231]
  128. Clin Imaging. 2021 Oct;78:206-213 [PMID: 34049140]
  129. J Ultrasound Med. 2019 Jan;38(1):179-189 [PMID: 29732585]
  130. Int J Gynecol Cancer. 2015 Sep;25(7):1258-65 [PMID: 26186070]
  131. Clin Imaging. 2021 Dec;80:36-42 [PMID: 34224952]
  132. Cancer. 2004 Feb 15;100(4):764-72 [PMID: 14770433]
  133. Medicine (Baltimore). 2021 Apr 9;100(14):e25434 [PMID: 33832146]
  134. Obstet Gynecol. 2013 Jan;121(1):136-42 [PMID: 23262938]
  135. Cancers (Basel). 2020 Nov 29;12(12): [PMID: 33260382]
  136. Gynecol Oncol. 2005 Oct;99(1):215-7 [PMID: 15979130]
  137. Gynecol Oncol. 2012 May;125(2):477-82 [PMID: 22245711]
  138. Int J Gynecol Pathol. 2019 Jan;38 Suppl 1:S64-S74 [PMID: 30550484]
  139. Eur Radiol. 2017 May;27(5):1867-1876 [PMID: 27631107]
  140. Radiol Bras. 2019 Jul-Aug;52(4):229-236 [PMID: 31435083]
  141. Arch Gynecol Obstet. 2018 Aug;298(2):373-380 [PMID: 29943129]
  142. World J Surg Oncol. 2015 Jun 25;13:208 [PMID: 26108802]
  143. Gynecol Oncol. 2021 Jun;161(3):795-801 [PMID: 33812697]
  144. J Gynecol Oncol. 2017 Nov;28(6):e86 [PMID: 29027404]
  145. PLoS Med. 2020 Sep 17;17(9):e1003263 [PMID: 32941469]
  146. Gynecol Oncol. 2021 Apr;161(1):152-159 [PMID: 33461741]
  147. Hum Reprod Update. 2022 Feb 28;28(2):282-295 [PMID: 34935045]
  148. BMC Fam Pract. 2018 Jul 30;19(1):135 [PMID: 30060741]
  149. Arch Gynecol Obstet. 2019 Jun;299(6):1673-1682 [PMID: 30953185]
  150. Pathol Oncol Res. 2021 Apr 01;27:611088 [PMID: 34257578]
  151. Radiother Oncol. 2021 Jan;154:327-353 [PMID: 33712263]
  152. Br J Cancer. 2015 Jul 14;113(2):299-310 [PMID: 26172027]
  153. Gynecol Oncol. 2021 Feb;160(2):413-417 [PMID: 33246662]
  154. Hum Reprod Update. 2017 Mar 1;23(2):232-254 [PMID: 27920066]
  155. Cancers (Basel). 2021 Jun 30;13(13): [PMID: 34208926]
  156. Int J Gynecol Cancer. 2005 Sep-Oct;15(5):974-8 [PMID: 16174254]
  157. Gynecol Oncol. 2020 Aug;158(2):347-353 [PMID: 32467056]
  158. Fertil Steril. 2001 Apr;75(4):803-5 [PMID: 11287038]
Journal Article

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Created with Highcharts 10.0.0treatmentendometrialcarcinomaguidelinespatientsmultidisciplinaryfertility-sparingECevidence-basedEuropeanrelevantfertilityrecommendationsdevelopmentgroupcareconsistingqualitycliniciansSocietyOncologyESGOprovideissuespreservationguidanceESGO/ESHRE/ESGEinternationalacrossEuropereviewedevidencebasedpatientprofessionalswomensurgeryBackground:standardsurgicaltotalhysterectomybilateralsalpingo-oophorectomydrasticallyaffectslifecreateschallengeRecentGynaecologicalSocieTyRadiotherapy&ESTROPathologyESPcomprehensivediagnosissettingalsoaddressingwork-uptreatmentsmanagementfollow-upconsideredextendsparingObjectives:defineMaterialsMethods:nominatedpracticingresearchersdemonstratedleadershipexpertiseresearch11expertsensureliteraturepublishedsince2016identifiedsystematicsearchcriticallyappraisedabsenceclearscientificjudgmentprofessionalexperienceconsensusthusbestavailableexpertagreementPriorpublication95independentpractitionerscancerdeliveryrepresentativesResults:formulated48foursections:selectiontumourclinicopathologicalcharacteristicsspecialConclusions:caringincludinglimitedfieldgynaecologicaloncologyonco-fertilityreproductiveendoscopyconservativehistopathologywillhelptowardsholisticapproachchallengingclinicalscenarioWhatnew?:collaborationsetESHREESGEaimingdevelopclinicallyfocusingkeyaspectsorderimproveworldwideGuidelines

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