Endometrial cancer medical therapy
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Risk calculators and risk factors for Endometrial cancer medical therapy |
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
| Risk | Risk definition | Management | Additional notes |
|---|---|---|---|
| Low risk | Women with stage IA endometrial cancer that is of endometroid histology and hasn't invaded the myometrium | Total hysterectomy, bilateral salpingo-oophorectomy, and lymph node evaluation | Women that opt for preservation of fertility may be candidates for medical therapy |
| Intermediate risk | ↔ | ↔ | ↓ |
| High risk | ↔ | ↓ | ↓ |
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.