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ORIGINAL ARTICLE

Endometrial Cancer State of the Science Meeting
Henry C. Kitchener,* Edward L. Trimble,Þ and for the Endometrial Cancer Working Group of the Gynecologic Cancer Intergroup

Abstract: There is a pressing need to improve our understanding of endometrial cancer (EC) and uterine carcinosarcoma and to develop new treatment strategies to improve outcomes. In recognition of this, aState of the Science meeting on EC was held last November 28 and 29, 2006, in Manchester, United Kingdom. The meeting was cosponsored by the National Cancer Research Institute (UK), the National Cancer Institute (US), and the Gynecological Cancer Intergroup. The objectives of the meeting were as follows: 1. To review current knowledge and understanding of EC and its treatments. 2. To identify keyissues for translational research and clinical trials. 3. To identify the most important trials for women with endometrial carcinoma and uterine carcinosarcoma, both those already underway or to be done, for which the Gynecological Cancer Intergroup might facilitate international cooperation. Key Words: Endometrial cancer, Clinical trials, Translational research (Int J Gynecol Cancer 2009;19:134Y140)

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ndometrial cancer (EC), the second most common gynecologic cancer worldwide, has now become the most common gynecologic cancer in developed countries. Its rising incidence is related to increasing life expectancy, tamoxifen use, and the epidemic of obesity. The last is also responsible for comorbidity, notably adultonset diabetes and hypertension. Together, comorbidity and obesitypresent challenges in delivering optimal therapy for many women with EC. The rising incidence of EC has been associated with a rising death rate. Although the prognosis of early disease is good with a survival rate of 80%, those with very high-risk disease and advanced disease at presentation have a survival rate below 50% with very little gain in therapeutic efficacy during the past 30 years. Thislack of progress in treatment is, in part, related to our limited understanding of the molecular pathology of EC. There is a pressing need to improve our understanding of EC and to develop new treatment strategies to improve outcomes. In addition, compared with ovarian and cervical cancer, EC and uterine carcinosarcoma (CS) have been studied much less extensively. Fewer trials have been opened forwomen with these cancers, and accrual to those trials has been slow. In recognition of this, a State of the Science meeting on EC was held last November 28 and 29, 2006 in Manchester, United Kingdom. The meeting was cosponsored by the National Cancer Research Institute (NCRI, UK), the National Cancer Institute

(US), and the Gynecological Cancer Intergroup (GCIG). A multidisciplinary group of75, drawing on surgeons, gynecologic oncologists, radiation (clinical) oncologists, medical oncologists, pathologists, translational scientists, and patient advocates from 18 countries and representing 14 trial groups attended. The objectives of the meeting were as follows: 1. To review current knowledge and understanding of EC and its treatments. 2. To identify key issues for translational researchand clinical trials. 3. To identify the most important trials for women with endometrial carcinoma and uterine CS, both those already underway or to be done, for which the GCIG might facilitate international cooperation. The first half of the proceedings was dedicated to a series of presentations, which outlined our current knowledge. The second half of the meeting began with parallel sessions ofearly disease and advanced/recurrent disease to define staging, treatment, and translational research issues to lead to candidate clinical trials questions. This was followed by plenary discussion of the questions to be addressed in these candidate trials and an attempt to develop an international consensus of the most favored concepts for future development and international collaboration. This...