Brazilian Society of Surgical Oncology guidelines for surgical treatment of endometrial cancer in regions with limited resources

Background Approximately 70% of cancer‐related deaths occur in low‐ and middle‐income countries. In addition to social and racial inequalities, treatment options in these countries are usually limited because of the lack of trained staff and equipment, limited patient access to health services, and...

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Published in:	Journal of surgical oncology Vol. 121; no. 5; pp. 730 - 742
Main Authors:	Ribeiro, Reitan, Fontes Cintra, Georgia, Barrozo, Abner, Tieko Tsunoda, Audrey, Pupo Nogueira, Alexandre, Andreazza Laporte, Gustavo, Araújo, Raphael Leonardo Cunha, Jara Reis, Rosilene, Patury, Patricia, Reis, Ricardo dos, Affonso, Renato José, Moretti Marques, Renato, Leal, Renato Mazon Lima Verde, Oliveira, Alexandre Ferreira, Henrique Zanvettor, Paulo, Oliveira Lopes, Francisco Carlos, Arenhart Pessini, Suzana, Lopes, André, Azevedo, Rafael Neiva, Assis Gobetti, Gustavo, Silva, Kelly Fernanda Pereira e, Andrade, Carlos Eduardo Mattos da Cunha, Carneiro, Vandré Cabral Gomes, Fin, Fabio Roberto, Castilho, Tiago Jacometo Coelho, Kwiatkowski, Filipe Vieira, Simões, João Carlos, Foiato, Tariane, Oliveira, Viviane Rezende, Augusto Casteleins, William, Filippi, Lucas Torelly, Zanini, Lucas Adalberto Geraldi, Maria Maués Sacramento, Raquel, Souza, Rafael Santos, Castro Lanaze, Gustavo, Barreto, Elio, Fonteles Ritt, Guilherme, Ziggiatti Güth, Gustavo, Sousa, Tiago Almeida, Cruz, Ricardo Pedrini, Schwengber, Alex, Bocanegra, Ronald Enrique Delgado, Silva, Jerônimo Paulo Assis, Tayeh, Muhamed Read Ali, Filho, Joaquim Delfino Neto, Gatelli, Charles Nilton, Adriano, Marcos Gonçalves, Toniazzi Lissa, Fernando, Oliveira Cucolicchio, Guilherme, Loureiro, Carlos Manoel Bulcão, Cunha, Juliano Rodrigues da, Lourenço Lira, Daniel, Araújo, Eliel Oliveira, Resende, Frederico Augustus Martins, Venâncio Pinto, Cláudio, Mendes Medeiros, Gustavo, Baiocchi, Glauco
Format:	Journal Article
Language:	English
Published:	United States Wiley Subscription Services, Inc 01-04-2020
Subjects:	Brazil Cancer surgery Colorectal Neoplasms, Hereditary Nonpolyposis - diagnosis Continuity of Patient Care Developing Countries Diagnostic Imaging Endometrial cancer endometrial neoplasms Endometrial Neoplasms - pathology Endometrial Neoplasms - surgery Female Fertility Preservation Health Services Accessibility Humans Hysterectomy limited resources Lymph Node Excision Neoplasm Recurrence, Local - therapy Neoplasm Staging Oncology Peritoneal Neoplasms - secondary Peritoneal Neoplasms - therapy Physical Examination practice guideline Referral and Consultation Sentinel Lymph Node Biopsy Societies, Medical surgery treatment Brazil limited resources treatment practice guideline endometrial neoplasms surgery
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Summary:	Background Approximately 70% of cancer‐related deaths occur in low‐ and middle‐income countries. In addition to social and racial inequalities, treatment options in these countries are usually limited because of the lack of trained staff and equipment, limited patient access to health services, and a small number of clinical guidelines. Objectives The Brazilian Society of Surgical Oncology developed this guideline to address these barriers and guide physicians treating patients with endometrial cancer (EC) in regions with limited resources and few specialized centers. Methods The guideline was prepared from 10 January to 25 October 20192019 by a multidisciplinary team of 56 experts to discuss the main obstacles faced by EC patients in Brazil. Thirteen questions considered critical to the surgical treatment of these patients were defined. The questions were assigned to groups that reviewed the literature and drafted preliminary recommendations. Following a review by the coordinators and a second review by all participants, the groups made final adjustments for presentations in meetings, classified the level of evidence, and voted on the recommendations. Results For all questions including staging, fertility spearing treatment, genetic testing, sentinel lymph node use, surgical treatment, and other clinical relevant questions, major agreement was achieved by the participants, always using accessible alternatives. Conclusions It is possible to provide adequate treatment for most EC patients in resource‐limited areas, but the first option should be referral to specialized centers with more resources.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Instructional Material/Guideline-2 ObjectType-Feature-3 content type line 23
ISSN:	0022-4790 1096-9098
DOI:	10.1002/jso.25797