Treatments

For diseases limited to the uterine body, clinically and radiologically, treatment most often begins with surgery (hysterectomy and lymph node removal). The anatomopathological examination then makes it possible to classify the disease according to 4 risk groups:

- low risk
- intermediate risk – low
- intermediate risk – high
- high risk

Depending on the risk group, the patient, a personalized treatment will be proposed at the end of a meeting: the multidisciplinary consultation meeting (RCP).
We can thus offer simple monitoring, vaginal brachytherapy, radiotherapy with brachytherapy, radio-chemotherapy + chemotherapy, chemotherapy, etc.

For diseases extending to the abdomen, the treatments will use chemotherapy, surgery, radiotherapy, according to a sequence adapted to the histological type of the disease, its extension and the patient.

The treatment recommendations generally follow those proposed by the ESMO (European Society of Medical Oncology), the French recommendations (SFOG – INCa, French Society of Gynecological Oncology) as well as the local recommendations (referential of the Institut Curie).< br> Screening for Lynch syndrome, by immunohistochemical study of MMR (mismatch repair) proteins, is done in most cases. This makes it possible to identify patients at risk of presenting this syndrome; and to identify so-called “unstable” tumors that may benefit from immunotherapy in certain circumstances.
In any case, the management of obesity, diabetes, arterial hypertension, other pathologies, are also part of the care plan.

Multidisciplinary Consultation Meeting (RCP): each case being specific, the file of each patient is discussed during a meeting where pathologists, surgeons, onco-geriatricians, medical oncologists, radiotherapists, radiologists, etc. are present. in order to establish an appropriate therapeutic plan.