指南与共识妇科

子宫内膜癌:妇科肿瘤学会循证综述与推荐(第二部分)

Endometrial cancer: A Society of Gynecologic Oncology evidence-based review and recommendations, part II.
指南 / 共识 · Gynecol Oncol · 2026-05-15

妇科肿瘤学会(SGO)临床实践委员会基于现有文献制定本循证综述与推荐,涵盖分子分型、遗传易感性、淋巴结评估、放化疗疗效及生存随访等进展。推荐采用ASCCP两级评分系统分级证据强度与质量,全文经SGO多个委员会及董事会批准。

要点

  • 推荐采用ASCCP两级评分系统对证据强度和质量进行分级。
  • 综述涵盖分子病理应用、遗传易感性、淋巴结评估及放化疗疗效等进展。
  • 强调子宫内膜癌发病率及死亡率持续上升背景下的治疗进展。

核心结论

  • 自2021年SGO临床实践委员会评审以来,子宫内膜癌领域在风险因素理解、分子分期、维持及靶向治疗等方面取得显著进展,但发病率与死亡率仍持续上升。
  • 本文件旨在全面综述上述进展并给出循证推荐。

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回顾现有文献并制定推荐,经SGO临床实践委员会、文件评审小组及董事会批准。

主要发现

  • 分子病理应用增加、遗传易感性理解加深、淋巴结评估方法改进、放化疗疗效认识拓宽及生存随访方法优化。

关键数值与推荐

  • 推荐分级采用ASCCP管理指南的两部分评分系统,分别评定推荐强度和证据质量,每条推荐后括注评分。

临床怎么用

  • 临床实践中应结合分子分型、遗传易感性评估、淋巴结评估及放化疗证据优化子宫内膜癌患者的治疗与随访。

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

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. The rating for each recommendation is given in parentheses.

来源:Gynecol Oncol,查看原文。版权归原作者所有。

引用

  1. Urban R, Eskander R, Westin S, et al. Endometrial cancer: A Society of Gynecologic Oncology evidence-based review and recommendations, part II. Gynecol Oncol. 2026. PMID: 42139816. doi:10.1016/j.ygyno.2026.05.006

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。