Endometrial cancer surgery: Difference between revisions
Jump to navigation
Jump to search
| Line 4: | Line 4: | ||
==Overview== | ==Overview== | ||
==Surgery== | ==Surgery== | ||
'''Stage I | '''Stage I endometrial Cancer''' | ||
* Standard treatment options: | * Standard treatment options: | ||
:* A total hysterectomy and bilateral salpingo-oophorectomy should be done if the tumor: | :* A total hysterectomy and bilateral salpingo-oophorectomy should be done if the tumor: | ||
| Line 14: | Line 14: | ||
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 | '''Stage II endometrial Cancer''' | ||
* Standard treatment options: | * Standard treatment options: | ||
:* If cervical involvement is documented, options include radical hysterectomy, bilateral salpingo-oophorectomy, and pelvic and para-aortic lymph node dissection. | :* If cervical involvement is documented, options include radical hysterectomy, bilateral salpingo-oophorectomy, and pelvic and para-aortic lymph node dissection. | ||
| Line 21: | Line 21: | ||
:* 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). | :* 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 | '''Stage III endometrial Cancer''' | ||
:* stage III endometrial cancer are treated with surgery, followed by chemotherapy, or radiation therapy, or both | :* stage III endometrial cancer are treated with surgery, followed by chemotherapy, or radiation therapy, or both | ||
Revision as of 14:54, 1 September 2015
|
Endometrial cancer Microchapters |
|
Diagnosis |
|---|
|
Treatment |
|
Case Studies |
|
Endometrial cancer surgery On the Web |
|
American Roentgen Ray Society Images of Endometrial cancer surgery |
|
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.