The MEDLINE (1966 to April 2004), CANCERLIT (1975 to October 2002), and Cochrane Library (2004, Issue 1) databases were searched using the Medical Subject Headings (MeSH) endometrial neoplasms, uterine neoplasms, and antineoplastic agents, and the following text words: endometrium, endometrial, serous, uterus, uterine, cancer, carcinoma, chemotherapy, hormone(s), hormonal. Search terms related to study design or publication type included systematic review, clinical trial, meta-analysis, controlled clinical trials, clinical trials/phase II, clinical trials/phase III, multicentre studies, and randomized controlled trials (MeSH). Proceedings of the 1997 to 2003 meetings of the American Society of Clinical Oncology (ASCO) and reference lists of papers and review articles were scanned for additional citations. The Canadian Medical Association Infobase (www.cma.ca/cma/common/start.do?lang=2) and the National Guidelines Clearinghouse (www.guideline.gov) Web sites were searched for existing evidence-based practice guidelines.
Inclusion Criteria
Evidence-based clinical practice guidelines or systematic reviews regarding systemic therapy for advanced disease from other guideline-development groups were eligible for inclusion.
To address the question regarding the chemotherapeutic and hormonal therapy options for women with advanced or recurrent endometrial cancer, full articles or abstracts were selected for inclusion if they met the following criteria:
- Randomized controlled trials (RCT) or meta-analyses comparing regimens of systemic chemotherapy or hormonal therapy to the standard treatment for advanced or recurrent endometrial cancer reporting at least one of the following outcomes: survival, quality of life, response rate, or toxicity
- RCTs that reported on heterogeneous populations (e.g., included women with a range of disease stages) were eligible if results were given separately for the group with advanced or recurrent endometrial cancer.
- When RCTs were not available, phase II trials of chemotherapy and hormonal therapy agents were included.
To address the question regarding the chemotherapeutic options for women with advanced or recurrent uterine papillary serous carcinoma (UPSC), full articles or abstracts were selected for inclusion if they met the following criteria:
- RCTs comparing systemic therapy regimens that included women with stage IIIc or IV uterine papillary serous carcinoma with measurable or evaluable disease at the start of systemic therapy, and reported at least one of the following outcomes: survival, quality of life, response rate, or toxicity
- When RCTs were not available, phase II trials of chemotherapy agents were included.
Exclusion Criteria
- Non-English language publications were excluded.
- Studies evaluating the role of radiotherapy, administered with chemotherapy or hormonal therapy, were excluded.