Endometrial cancer medical therapy: Difference between revisions
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==Medical Therapy== | ==Medical Therapy== | ||
'''Stage I Endometrial Cancer''' | '''Stage I Endometrial Cancer''' | ||
:* A total [[hysterectomy]] and bilateral [[salpingo-oophorectomy]] should be done. | :* 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 | :* Selected pelvic lymph nodes may be removed. If they are negative, no postoperative treatment is indicated. | ||
'''Stage II Endometrial Cancer''' | '''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 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. | :* 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''' | '''Stage III Endometrial cancer''' | ||
:* Patients with stage III endometrial cancer are treated with [[surgery]], followed by [[chemotherapy]], or [[radiation therapy]], or both. | :* 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. | :* 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''' | '''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. | :* 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. | ||
Revision as of 15:22, 29 November 2018
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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
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.