[Endometrial carcinoma--what are the protocols for?].

Introduction: Endometrial cancer accounts for 10% of all malignant diseases affecting women in Western Europe. Women suffering from colonic, breast and ovarian cancer are at higher risk for developing endometrial carcinoma, which points to the fact that some women have a genetic predisposition for developing endometrial cancer. Precancerous conditions, adenomatous hyperplasias, are rarely diagnosed in our institutions. Treatment of endometrial cancer is individual, but surgeons are required to follow some treatment protocols. The aim of this study was to analyze how well treatment protocols are known and used

Material And Methods: This study analyzed parameters of treatment of patients with endometrial cancer treated in two institutions treating oncologic patients in Novi Sad during a ten-year period (1991-2000). Results were obtained from patient records, specialist reports, surgery reports and history of disease.

Results: The investigation included 450 patients undergoing surgery for endometrial cancer. The average age was 62.5 years. Most patients underwent surgery in stage one (69.1%), two (14.57%), three (9.38%), zero (3.95%) and stage four (2.96%). Surgeries were performed by 16 surgeons, but none of them performed a standard treatment protocol completely. During the last 10 years 10% of patients did not undergo postoperative radiotherapy, due to outworn facilities and follow up of these patients by control of tumor markers was particularly important.

Discussion: The stage distribution of cancers is corresponding to that stated in literature. In regard to surgical approach and using treatment protocols, our surgeons stand behind their foreign colleagues. According to treatment standards of oncologic patients in developed countries, only specialised gynecologists and surgeons oncologists can perform operative treatment of oncologic patients. In regard to criteria in the leading countries of the world, 18 surgical gynecologists oncologists (23 the maximum) are sufficient for the territory of Serbia.

Conclusion: Inadequate primary surgical treatment significantly increases the cost of therapy by late reoperations or additional postoperative treatment and has a negative effect on survival. In order to group patients and provide a well-educated staff with full work-time and adequate facilities, two (maximum three) institutions are sufficient at the territory of Vojvodina.