J Gynecol Oncol.  2009 Jun;20(2):107-112. 10.3802/jgo.2009.20.2.107.

Surgical practice patterns in endometrial cancer: results of the Korean Gynecologic Oncology Group survey

• Lee TS
• Kim JW
• Kim SH
• Seong SJ
• Song ES
• Kim JH
• Kim JH
• Park NH
• Lee KH
• Lee NW
• Ryu HS

• KMID: 2245093
• DOI: http://doi.org/10.3802/jgo.2009.20.2.107

Abstract

OBJECTIVE
This study was undertaken to document current practice patterns for the surgical treatment of endometrial cancer in Korea.
METHODS
Questionnaires were distributed to 131 Korean gynecologic oncologists, all members of the Korean Gynecologic Oncology Group. Questions addressed extent of hysterectomy procedure, pelvic (PEN) or paraaortic (PAN) lymph node dissection, ovarian preservation, and omentectomy.
RESULTS
Completed questionnaires were returned by 64.1% (84/131) of the oncologists at 50 institutes. Extrafascial hysterectomy (EH) was used by 32% of respondents and modified radical hysterectomy (MRH) or radical hysterectomy (RH) by 17%. Hysterectomy procedures were selectively employed based on tumor-related factors by 51% of the respondents. Laparoscopic hysterectomy was routinely utilized by 49% and was more commonly used by younger surgeons with 10 years of experience or less. PEN dissection was routinely utilized by 67% and was used selectively based on tumor-related factors by 33%. PAN dissection/biopsy was used either routinely (43%) or selectively based on tumor-related factors (43%). PAN dissection/biopsy had never been employed by 12% of the respondents. Sixty-nine percent of respondents stated that grossly normal looking ovaries can be preserved during surgery in young aged patients with early stage disease, and 29% stated that bilateral oophorectomy should be performed irrespective of age or stage. Omentectomy was routinely performed by 11% of respondents, and was selectively performed when extrauterine spread was present by 41%.
CONCLUSION
Surgical procedures for the treatment of endometrial cancer are still not standardized among Korean gynecologic surgeons. Clinical trials to determine the benefits of the different surgical procedures should be developed.

Keyword

Practice pattern; Endometrial cancer

MeSH Terms

Academies and Institutes
Aged
Surveys and Questionnaires
Endometrial Neoplasms
Female
Humans
Hysterectomy
Korea
Lymph Node Excision
Ovariectomy
Ovary

Figure

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  Fig. 1 Experiences of respondents; (A) Duration of exposure to endometrial cancer surgery, (B) Number of cases of endometrial cancer surgery treated per respondent.

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  Fig. 2 Use of laparoscopic hysterectomy for the treatment of endometrial cancer.

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  Fig. 3 Lymph node dissection policies during endometrial cancer surgery. LND: lymph node dissection, LNS: lymph node sampling

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