Endometrial cancer surgery: Difference between revisions
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==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. | ::* Is well or moderately differentiated. | ||
:* Involves the upper 66% of the corpus. | ::* Involves the upper 66% of the corpus. | ||
:* Has negative peritoneal cytology. | ::* Has negative peritoneal cytology. | ||
:* Is without vascular space invasion. | ::* Is without vascular space invasion. | ||
:* Has less than a 50% myometrial 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 | '''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. | |||
==References== | ==References== | ||
Revision as of 14:54, 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.