Endometrial cancer surgery: Difference between revisions
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__NOTOC__ | __NOTOC__ | ||
{{Endometrial cancer}} | {{Endometrial cancer}} | ||
{{CMG}} | {{CMG}}{{AE}}{{MD}} | ||
==Overview== | ==Overview== | ||
==Surgery== | ==Surgery== | ||
'''Stage I Endometrial Cancer''' | |||
:* Standard treatment options: | |||
::* A total hysterectomy and bilateral salpingo-oophorectomy should be done if the tumor: | |||
:* Is well or moderately differentiated. | |||
Standard treatment options: | :* Involves the upper 66% of the corpus. | ||
A total hysterectomy and bilateral salpingo-oophorectomy should be done if the tumor: | :* Has negative peritoneal cytology. | ||
:* Is without vascular space invasion. | |||
Is well or moderately differentiated. | :* Has less than a 50% myometrial invasion. | ||
Involves the upper 66% of the corpus. | |||
Has negative peritoneal cytology. | |||
Is without vascular space invasion. | |||
Has less than a 50% myometrial invasion. | |||
Selected pelvic lymph nodes may be removed. If they are negative, no postoperative treatment is indicated. Postoperative treatment with a vaginal cylinder is advocated by some clinicians. | Selected pelvic lymph nodes may be removed. If they are negative, no postoperative treatment is indicated. Postoperative treatment with a vaginal cylinder is advocated by some clinicians. | ||
Stage II Endometrial Cancer | Stage II Endometrial Cancer | ||
Standard treatment options: | Standard treatment options: | ||
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When possible, patients with stage IV endometrial cancer are treated with surgery, followed by chemotherapy, or radiation therapy, or both. | When possible, patients with stage IV endometrial cancer are treated with surgery, followed by chemotherapy, or radiation therapy, or both. | ||
==References== | ==References== | ||
Revision as of 14:38, 1 September 2015
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Endometrial cancer Microchapters |
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Diagnosis |
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Treatment |
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Case Studies |
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Endometrial cancer surgery On the Web |
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American Roentgen Ray Society Images of Endometrial cancer surgery |
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Risk calculators and risk factors for Endometrial cancer surgery |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Monalisa Dmello, M.B,B.S., M.D. [2]
Overview
Surgery
Stage I Endometrial Cancer
- Standard treatment options:
- A total hysterectomy and bilateral salpingo-oophorectomy should be done if the tumor:
- Is well or moderately differentiated.
- Involves the upper 66% of the corpus.
- Has negative peritoneal cytology.
- Is without vascular space invasion.
- Has less than a 50% myometrial invasion.
Selected pelvic lymph nodes may be removed. If they are negative, no postoperative treatment is indicated. Postoperative treatment with a vaginal cylinder is advocated by some clinicians. Stage II Endometrial Cancer Standard treatment options: 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. Current Clinical Trials The completed GOG-LAP2 trial included 2,616 patients with clinical stage I to IIA disease and randomly assigned them two-to-one to comprehensive surgical staging via laparoscopy or laparotomy.The recurrence rate at 3 years was 10.24% for patients in the laparotomy arm, compared with 11.39% for patients in the laparoscopy arm, with an estimated difference between groups of 1.14% (90% lower bound, -1.278; 95% upper bound, 3.996).
Stage III Endometrial Cancer stage III endometrial cancer are treated with surgery, followed by chemotherapy, or radiation therapy, or both
stage IV endometrial cancer When possible, patients with stage IV endometrial cancer are treated with surgery, followed by chemotherapy, or radiation therapy, or both.