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.

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