Endometrial cancer surgery
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Shankar Kumar, M.B.B.S. [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.
Radiation Therapy
Women with stage 1 disease who are at increased risk for recurrence and those with stage 2 disease are often offered surgery in combination with radiation therapy.