Status of surgical treatment procedures for endometrial cancer in Japan: Results of a Japanese Gynecologic Oncology Group Survey

Objective.: We investigated the current status of surgical procedures for endometrial carcinoma in Japan by surveying members of the Japan Gynecologic Oncology Group (JGOG). Methods.: A mail survey focusing on hysterectomy procedures, indications for radical hysterectomy, methods for detecting pelvic (PEN) and para-aortic lymph node (PAN) status, and indications for PAN dissection/biopsy, was sent to all 215 authorized JGOG member institutions. Results.: A total of 139 (57.2%) members responded to the survey. Abdominal total hysterectomy (TAH) was utilized by 35.3% of institutions and Piver class II extended hysterectomy by 30.2%. In 35.5% of institutions, hysterectomy procedures were selectively employed based on tumor-related factors. Radical hysterectomy (RH) was utilized by 29.5% of institutions; TAH was used significantly more frequently by specialist hospitals while RH was significantly less commonly utilized by specialist hospitals compared with university hospitals and general hospitals. PEN dissection was routinely utilized by 97.8% of institutions. In 93.5% of institutions, PAN dissection/biopsy was used either routinely (12.2%) or selectively based on tumor-related factors (81.2%). In 6.5% of institutions, PAN dissection/biopsy has never been employed. Conclusion.: The status of surgical procedures for the treatment of endometrial cancer is still not standardized. However, TAH, bilateral salpingo-oophorectomy, PEN dissection, and PAN dissection/biopsy in selected cases are recent surgical procedures used for the treatment of endometrial cancer in Japan. Clinical trials to determine the survival benefit of the different surgical procedures should be developed to determine the standard surgical procedures to be used for the treatment of endometrial cancer.