Endometrial cancer surgery

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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

The feasibility of surgery depends on the stage of endometrial cancer at diagnosis. Surgery is the mainstay of treatment for endometrial cancer stage(I-III).

Surgery

Stage I Endometrial cancer

• 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

• 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

• The patients 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

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