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ACR Appropriateness Criteria® Advanced Stage Endometrial Cancer

Expert Panel on Radiation Oncology-Gynecology:; Elshaikh, Mohamed A. MD*; Yashar, Catheryn M. MD; Wolfson, Aaron H. MD; Cardenes, Higinia Rosa MD, PhD§; Erickson, Beth MD; Jhingran, Anuja MD; Jolly, Shruti MD#; Kidd, Elizabeth MD**; Lee, Larissa J. MD††; Mayr, Nina A. MD‡‡; Moore, David MD§§; Rao, Gautam G. MD∥∥; Small, William Jr MD¶¶; Varia, Mahesh A. MD##; Wahl, Andrew O. MD***; Yuh, William MD†††; Gaffney, David K. MD, PhD‡‡‡

American Journal of Clinical Oncology: August 2014 - Volume 37 - Issue 4 - p 391–396
doi: 10.1097/COC.0000000000000098
ACR Appropriateness Criteria

Objectives: Patients with advanced stage endometrial carcinoma constitute a heterogeneous group of patients with different stages, tumor histologic types, and involved sites. Hysterectomy, bilateral salpingo-ophorectomy, and surgical staging are the cornerstone of surgical management in these patients. The optimal adjuvant therapy is yet to be established. An expert panel was convened to reach consensus on the most appropriate management options in this group of patients.

Methods: The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed every 3 years by a multidisciplinary expert panel. The guideline development and review include an extensive analysis of current medical literature from peer-reviewed journals and the application of a well-established consensus methodology (modified Delphi) to rate the appropriateness of imaging and treatment procedures by the panel. In those instances where evidence is lacking or not definitive, expert opinion may be used to recommend imaging or treatment.

Results: Four clinical variants were developed to address common scenarios in the management of women with advanced-stage endometrial carcinoma. Group members reached consensus on the appropriateness of specific evaluation and treatment approaches with numerical ratings.

Conclusions: In combining available medical literature and expert opinions, this manuscript may serve as an aid for other practitioners in the appropriate management of women with advanced-stage endometrial carcinoma.

*Department of Radiation Oncology, Henry Ford Health System, Detroit

#University of Michigan Health System, Ann Arbor, MI

University of California San Diego, San Diego, CA

**Stanford Cancer Center, Stanford, CA

University of Miami, Miami, FL

§Indiana University Medical Center, Indianapolis, IN

§§Indiana University School of Medicine, Indianapolis, IN (American College of Obstetricians and Gynecologists)

Medical College of Wisconsin, Milwaukee, WI

University of Texas, MD Anderson Cancer Center, Houston, TX

††Brigham and Women’s Hospital/Dana-Farber Cancer Institute, Boston, MA

‡‡UW Medicine, University of Washington, Seattle, WA

†††Fred Hutchinson Cancer Center, University of Washington, Seattle, WA

∥∥University of Maryland School of Medicine, Baltimore, MD (American Society of Clinical Oncology)

¶¶Stritch School of Medicine Loyola University Chicago, Maywood, IL

##University of North Carolina School of Medicine, Chapel Hill, NC

***University of Nebraska Medical Center, Omaha, NE

‡‡‡University of Utah Medical Center, Salt Lake City, UT

The authors declare no conflicts of interest.

The American College of Radiology seeks and encourages collaboration with other organizations on the development of the ACR Appropriateness Criteria through society representation on expert panels. Participation by representatives from collaborating societies on the expert panel does not necessarily imply individual or society endorsement of the final document.

This article is a revised version of the American College of Radiology Appropriateness Criteria Advanced Stage Endometrial Cancer, excerpts of which are reprinted here with permission. Practitioners are encouraged to refer to the complete version at

Reprints: Mohamed A. Elshaikh, MD, Department of Radiation Oncology, Henry Ford Health System, 2799W Grand Blvd M2, Detroit, MI 48202-2689. E-mail:

© 2014 by Lippincott Williams & Wilkins, Inc