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Shogo Shigeta,Satoru Nagase,Mikio Mikami,Masae Ikeda,Masako Shida,Isao Sakaguchi,Norichika Ushioda,Fumiaki Takahashi,Wataru Yamagami,Nobuo Yaegashi,Yasuhiro Udagawa,Hidetaka Katabuchi 대한부인종양학회 2017 Journal of Gynecologic Oncology Vol.28 No.6
Objective: The Japan Society of Gynecologic Oncology (JSGO) published the first practiceguideline for endometrial cancer in 2006. The JSGO guideline evaluation committee assessedthe effect of this guideline introduction on clinical practice and patient outcome using dataprovided by the Japan Society of Obstetrics and Gynecology (JSOG) cancer registration system. Methods: Data of patients with endometrial cancer registered between 2000 and 2012 wereanalyzed, and epidemiological and clinical trends were assessed. The influence of guidelineintroduction on survival was determined by analyzing data of patients registered between2004 and 2009 using competing risk model. Results: In total, 65,241 cases of endometrial cancer were registered. Total number ofpatients registered each year increased about 3 times in the analyzed period, and theproportion of older patients with type II endometrial cancer rapidly increased. The frequencyof lymphadenectomy had decreased not only among the low-recurrence risk group but alsoamong the intermediate- or high-recurrence risk group. Adjuvant therapy was integratedinto chemotherapy (p<0.001). Overall survival did not significantly differ before and afterthe guideline introduction (hazard ratio [HR]=0.891; p=0.160). Additional analyses revealedpatients receiving adjuvant chemotherapy showed better prognosis than those receivingadjuvant radiation therapy when limited to stage I or II (HR=0.598; p=0.003). Conclusion: It was suggested that guideline introduction influenced the managementof endometrial cancer at several aspects. Better organized information and continuousevaluation are necessary to understand the causal relationship between the guideline andpatient outcome.