Summary Recommendations

Guideline Recommendations

What is the Role of Chemotherapy Following Surgery in Women Diagnosed with Endometrial Cancer?

It was unanimously agreed by all members of the workgroup that the NCCN guidelines version 2.2015, regarding the use of adjuvant chemotherapy in endometrial (uterine) carcinoma (EC), were sufficiently comprehensive and evidence-based for it to be adopted in Singapore. Adjuvant chemotherapy should be offered to patients with endometrial cancer stage III/IV. Chemotherapy could be offered to women with stage 1B or II, grade III, with adverse risk factors, due to higher risk of extrapelvic relapse and possible benefit.

What are the Chemotherapeutic Options for Women with Advanced or Recurrent Endometrial Cancers?

The group unanimously endorsed the ESMO guidelines 2013 on the treatment of advanced endometrial cancer as it was felt to be the most comprehensive among the 3 chosen guidelines. The use of taxane - platinum-based chemotherapy should be considered as standard of care (in comparison to platinum-non-taxane combination); while the use of hormones can be considered. There is data to support the role of mTOR inhibitors in patients with metastatic/recurrent endometrioid endometrial cancer following failure of first-line chemotherapy.

What is the Role of Chemotherapy in Women with Uterine Papillary Serous Carcinoma or Clear Cell Carcinoma?

The group unanimously endorsed the NCCN guidelines version 2.2015 on the treatment of uterine papillary serous carcinoma or clear cell carcinoma. All the members agree that chemotherapy should be recommended for all stages of UPSC/clear cell, including stage I disease. NCCN recommendations were considered to be the most comprehensive and to best represent the current evidence.

ESMO: European Society of Medical Oncology; NCCN: National Cancer Comprehensive Network; UPSC: Uterine papillary serous carcinoma