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Management of uterine carcinomas

机译：子宫癌的治疗

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Uterine carcinomas are 2 main different entities: endometrial carcinomas and cervical carcinomas. Endometrial carcinomas are hormonosensitive lesions of the old woman. Management of these tumors is adapted to the histologic type, histologic grade (grade 1 to 3 in relation with the differentiation status), the FIGO stage and the presence of lymph-vascular space invasion of the lesion. Cervical carcinomas are mainly of epidermoid histologic type. They are observed in young women and are related to human papillomavirus infection. The prognosis of theses tumors is related to the FIGO stage and the extension of the lymph-node metastasis. Endometrial carcinomas are usually discovered at early stage and the principal treatment should be surgery: laparoscopic total hysterectomy + bilateral oophorectomy. The evaluation of the lymph-nodal status is debated. Recommended adjuvant treatments are mainly radiotherapy which is performed in case of bad prognostic factors. For cervical carcinomas, in case of early stage, management is mainly surgical: radical hysterectomy with sentinel node dissection. For advanced lesions (more than 4 cm in maximal diameter) recommended treatment is radiotherapy + chemopotentialisation. These tumors are good prognostic lesions with 5 years overall survival of more of 80 % when they are discovered at an early stage and adequately treated. (C) 2016 Elsevier Masson SAS. All rights reserved.
机译：子宫癌是两个主要的不同实体：子宫内膜癌和宫颈癌。子宫内膜癌是老女人的激素敏感性病变。这些肿瘤的治疗适应于组织学类型，组织学等级（与分化状态有关的等级为1至3），FIGO分期以及病变的淋巴-血管间隙浸润的存在。宫颈癌主要是表皮样组织学类型。它们在年轻妇女中观察到，并且与人乳头瘤病毒感染有关。这些肿瘤的预后与FIGO分期和淋巴结转移的扩展有关。子宫内膜癌通常在早期发现，主要治疗应为手术：腹腔镜全子宫切除术+双侧卵巢切除术。对淋巴结状态的评估存在争议。推荐的辅助治疗方法主要是放疗，如果预后不良，则应进行放疗。对于子宫颈癌，在早期情况下，处理主要是外科手术：根治性子宫切除术和前哨淋巴结清扫术。对于晚期病变（最大直径超过4厘米），建议的治疗方法是放疗+化学势化。这些肿瘤是良好的预后性病变，如果在早期发现并进行适当治疗，其5年总生存率可达80％以上。 （C）2016 Elsevier Masson SAS。版权所有。

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