title: Analysis of the evolution in the management of endometrial cancer in Italy: a CTF study.
abstract: OBJECTIVE
  In 1994 we mailed questionnaires to referral centers in Italy in order to evaluate the different opinions concerning aspects of endometrial cancer treatment, which is still controversial. The data processing showed a significant nonhomogeneity in disease management and prompted the Italian Society of Gynecologic Oncology to define guidelines for endometrial cancer adjuvant treatment. In 2001, we mailed again the same questionnaire to the same referral Centers in Italy. The aim of the second enquiry was the evaluation of changes in endometrial cancer management and the effective impact of the guidelines published.
  
  
  METHODS
  The enquiry used the same questionnaires mailed in 1994; actually, we mailed those questionnaires to the same referral centers in Italy twice: in December 2000 and March 2001. The results of both the enquiries were collected in a relational data base, and the statistical evaluations were calculated using SPSS-statistics (Window ver. 8).
  
  
  RESULTS
  Endometrial cancer treatment consists in abdominal hysterectomy and bilateral salpingo-oophorectomy. The unique relevant difference as to 1994 consists in the systemic performing of peritoneal cytology in endometrial cancer staging. Unlike the previous enquiry, adjuvant radiotherapy is not systematically performed in disease at stage Ic because of the substantial absence of confirmed data demonstrating a real benefit in terms of survival rate. The comparison between the two enquiries shows a significant change in medical planning and diversification attitude according to patient age and menopausal state. The disease management changes in patients over 75 years old, mainly with respect to surgery and primary therapy.
  
  
  CONCLUSIONS
  We noted a resistance of many centers to accept some trends actually widespread in the literature but not yet performed in practical clinical.
authors.affiliation: Cattedra di Ginecologia Oncologica, Ospedale Mauriziano Umberto 1, Torino, Italy. pzola@mauriziano.it
authors.forename: Paolo
authors.initials: P
authors.lastname: Zola
authors.forename: Maria Elena
authors.initials: ME
authors.lastname: Jacomuzzi
authors.forename: Simona
authors.initials: S
authors.lastname: Mazzola
authors.forename: Luca
authors.initials: L
authors.lastname: Fuso
authors.forename: Annamaria
authors.initials: A
authors.lastname: Ferrero
authors.forename: Fabio
authors.initials: F
authors.lastname: Landoni
authors.forename: Angiolo
authors.initials: A
authors.lastname: Gadducci
authors.forename: Enrico
authors.initials: E
authors.lastname: Sartori
authors.forename: Tiziano
authors.initials: T
authors.lastname: Maggino
mesh_terms: D000367:Age Factors; D002173:Cancer Care Facilities / Q000706:statistics & numerical data*; D017024:Chemotherapy, Adjuvant; D015897:Comorbidity; D016889:Endometrial Neoplasms / Q000473:pathology* / Q000628:therapy*; D005260:Female; D019983:Guideline Adherence; D006801:Humans; D007558:Italy; D008207:Lymphatic Metastasis; D008593:Menopause; D020360:Neoadjuvant Therapy; D009367:Neoplasm Staging; D017410:Practice Guidelines as Topic; D018714:Radiotherapy, Adjuvant; D011795:Surveys and Questionnaires