Brazilian Society of Surgical Oncology guidelines for surgical treatment of endometrial cancer in regions with limited resources
Authors: Ribeiro Reitan , Fontes Cintra Georgia , Barrozo Abner , Tieko Tsunoda Audrey , Pupo Nogueira Alexandre , Andreazza Laporte Gustavo , de 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 , de Oliveira Lopes Francisco Carlos , Arenhart Pessini Suzana , Lopes André , de Azevedo Rafael Neiva , de Assis Gobetti Gustavo , Silva Kelly Fernanda Pereira e , Andrade Carlos Eduardo Mattos da Cunha , Carneiro Vandré Cabral Gomes , Fin Fabio Roberto , de Castilho Tiago Jacometo Coelho , Kwiatkowski Filipe Vieira , Simões João Carlos , Foiato Tariane , de Oliveira Viviane Rezende , Augusto Casteleins William , Filippi Lucas Torelly , Zanini Lucas Adalberto Geraldi , de Maria Maués Sacramento Raquel , de Souza Rafael Santos , Castro Lanaze Gustavo , Barreto Elio , Fonteles Ritt Guilherme , Ziggiatti Güth Gustavo , de Sousa Tiago Almeida , Cruz Ricardo Pedrini , Schwengber Alex , Bocanegra Ronald Enrique Delgado , da Silva Jerônimo Paulo Assis , Tayeh Muhamed Read Ali , Filho Joaquim Delfino Neto , Gatelli Charles Nilton , Adriano Marcos Gonçalves , Toniazzi Lissa Fernando , de Oliveira Cucolicchio Guilherme , Loureiro Carlos Manoel Bulcão , Cunha Juliano Rodrigues da , Lourenço Lira Daniel , de Araújo Eliel Oliveira , de Resende Frederico Augustus Martins , Venâncio Pinto Cláudio , Mendes Medeiros Gustavo , Baiocchi Glauco 
Published: December 2019

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.