RT Journal Article
SR Electronic
T1 Utility and Actual Use of European and Spanish Guidelines on the Management of Endometrial Cancer Among Gynecologic Oncologists in Spain
JF International Journal of Gynecologic Cancer
JO Int J Gynecol Cancer
FD BMJ Publishing Group Ltd
SP 1293
OP 1297
DO 10.1097/IGC.0000000000001017
VO 27
IS 6
A1 Ignacio Zapardiel
A1 Claudia Blancafort
A1 David Cibula
A1 Ibon Jaunarena
A1 Mikel Gorostidi
A1 Antonio Gil-Moreno
A1 Javier De Santiago
YR 2017
UL http://ijgc.bmj.com/content/27/6/1293.abstract
AB Objective The aim of the study was to analyze the current management of endometrial cancer across Spain and to evaluate the use and applicability of the national and international guidelines.Materials and Methods An electronic 30-question survey was distributed among all Spanish Society of Obstetrics and Gynecology–registered specialists dedicated to gynecologic oncology in Spain by e-mail. Data were collected anonymously and analyzed using SPSS program.Results One hundred forty-five (17.8%) surveys were collected. Significant differences were observed between tertiary hospitals and secondary or private hospitals in terms of appropriate (according to European Society of Gynaecologic Oncology guidelines) nodal staging in low-risk cases (96 [95%] vs 27 [61.4%], respectively; P < 0.001), appropriate nodal staging in intermediate-risk cases (96 [95%] vs 39 [88.6%], respectively; P = 0.004), appropriate treatment in advanced-stage cases (63 [67.7%] vs 13 [40.6%], respectively; P < 0.001), and surgical treatment of relapses (87 [93.5%] vs 18 [56.3%], respectively; P = 0.004) but nonsignificant in the rate of complete paraaortic lymphadenectomy performance (82 [81.2%] vs 28 [63.6%], respectively; P = 0.056). Similar results have been observed when comparing centers with less than 20 cases per year to centers with more than 40 cases annually, with significant differences in the management of low-risk and intermediate-risk endometrial cancers.Conclusions This cross-sectional study demonstrates a broad heterogeneity of care giving between the clinical national and international guidelines and the actual practice in Spain. Although most of the responders refer to base their endometrial cancer management on Spanish and European Society of Gynaecologic Oncology guidelines (64.1%), many discrepancies have been observed, mainly in the management of intermediate-risk cases and follow-up. It may be caused by the lack of consensus on certain points, lack of facilities in lower case load centers, and also due to disagreement or unawareness on the current knowledge.