子宫内膜癌:妇科肿瘤学会循证综述与推荐第一部分
该文献为妇科肿瘤学会(SGO)临床实践委员会发布的子宫内膜癌循证综述与推荐第一部分,由妇科肿瘤专家小组基于现有文献制定,采用ASCCP两级评级系统对推荐强度和证据质量进行分级。文章综述了分子分型、遗传易感性、淋巴结评估、放化疗疗效及生存随访等方面的进展。
要点
- 推荐采用分子分型用于子宫内膜癌的评估。
- 需重视遗传易感性评估。
- 优化淋巴结评估方法。
核心结论
- 自2021年SGO临床实践委员会评审以来,子宫内膜癌在危险因素理解、分子分型加入、维持治疗和靶向治疗扩展使用等方面取得显著进展。
研究设计与样本
- 由SGO临床实践委员会成员及领域专家组成的小组基于当前子宫癌文献证据制定,采用ASCCP两级评级系统对推荐强度和证据质量进行分级,并经SGO临床实践委员会、文件审查小组和董事会批准。
主要发现
- 子宫内膜癌的发病率和归因于该疾病的死亡人数持续上升。
- 在分子病理学应用、遗传易感性理解、淋巴结评估方法、放化疗疗效理解以及生存随访方法等方面均取得了进展。
以上解读依据论文摘要(全文未开放获取或许可不允许翻译转载)。
原文
INTRODUCTION: In the time since the last Clinical Practice Committee review of treatment of women with endometrial cancer in 2021, the field of gynecologic oncology has seen significant changes in endometrial cancer from understanding risk factors, addition of molecular staging, and expanded use of maintenance and targeted therapies. Despite these advances, the incidence of endometrial cancer as well as the deaths attributable to the disease continued to rise. Fortunately, since then, there has been progress in the treatment of patients with endometrial cancer, including increased utilization of molecular pathology, greater understanding of genetic predisposition, enhanced methods for lymph node assessment, a broader understanding of the efficacy of radiation and chemotherapy, and a more efficient approach to survivorship and surveillance. The purpose of this document is to present a comprehensive review of this progress. MANUSCRIPT DEVELOPMENT PROCESS: The authors reviewed the available evidence, contributed to the development of this manuscript, provided critical review of the guidelines, and finalized the manuscript recommendations. The review was also presented to and approved by the Society of Gynecologic Oncology (SGO) Clinical Practice Committee, Document Review Panel, and the Board of Directors prior to submission for publication. The recommendations for this manuscript were developed by a panel of gynecologic oncologists who were members of the SGO Clinical Practice Committee and subject matter experts. Panelists reviewed and considered evidence from current uterine cancer literature. The terminology used in these guidelines was adopted from the ASCCP management guidelines [1] using a two-part rating system to grade the strength of recommendation and quality of evidence (Table 1). The rating for each recommendation is given in parentheses.
引用
- Urban R, Castellano T, Doll K, et al. Endometrial cancer: A Society of Gynecologic Oncology evidence-based review and recommendations: Part I. Gynecol Oncol. 2026. PMID: 42048941. doi:10.1016/j.ygyno.2026.04.004
供执业医师工作参考,不替代临床判断;数值与分级以指南原文为准。