Endometrial cancer medical therapy

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

The optimal therapy for endometrial cancer depends on the stage at diagnosis. A combination of chemotherapy and radiation therapy is indicated in stages IIIB- IV.

Medical Therapy

Risk	Risk definition	Management	Additional notes
Low risk	Women with stage IA endometrial cancer that is of endometroid histology and hasn't invaded the myometrium	Total hysterectomy, bilateral salpingo-oophorectomy, and lymph node evaluation	Women that opt for preservation of fertility may be candidates for medical therapy
Intermediate risk	↔	↔	↓
High risk	↔	↓	↓

Stage I Endometrial Cancer

• A total hysterectomy and bilateral salpingo-oophorectomy should be done.
• Selected pelvic lymph nodes may be removed. If they are negative, no postoperative treatment is indicated.

Stage II Endometrial Cancer

• If cervical involvement is documented, options include radical hysterectomy, bilateral salpingo-oophorectomy, and pelvic and para-aortic lymph node dissection.
• If the cervix is clinically uninvolved but extension to the cervix is documented on postoperative pathology, radiation therapy should be considered.

Stage III Endometrial cancer

• Patients with stage III endometrial cancer are treated with surgery, followed by chemotherapy, or radiation therapy, or both.
• Patients with inoperable disease caused by tumor that extends to the pelvic wall may be treated with a combination of chemotherapy and radiation therapy. The usual approach is to use a combination of intracavitary radiation therapy and external-beam radiation therapy.

Stage IV Endometrial cancer

• Treatment of patients with stage IV endometrial cancer is dictated by the site of metastatic disease and symptoms related to disease sites. For bulky pelvic disease, radiation therapy consisting of a combination of intracavitary and external-beam radiation therapy is used.

References

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