Interpretation of 2015 NCCN clinical practice guidelines of endometrial uterine cancers

Abstract

Version 2015 of the National Comprehensive Cancer Network (NCCN) Guidelines for Uterine Neoplasms uses the 2009 International Federation of Gynecology and Obstetrics(FIGO) staging system. These NCCN guidelines divide pure endometrioid cancers into three categories to delineate treatment: ⑴ disease limited to the uterus; ⑵ cervical involvement; ⑶ extrauterine disease. Surgery is recommended for medically operable patients. Continuous progestin-based therapy may be considered for highly selected patients with stage IA disease who wish to preserve their fertility. Preoperative chemotherapy can be considered if extrauterine disease is suspected. Factors that may influence the decision regarding adjuvant therapy include lymph vascular space invasion (LVSI), patient age, tumor volume, and lower uterine segment or surface cervical glandular involvement. When administering adjuvant radiotherapy, it should be initiated as soon as the vaginal cuff has healed, no later than 12 weeks after surgery. Key words: Endometrial neoplasms; Guidebooks