Treatment
Consult expert advice.
Treatment options for endometrial cancer include:
- surgical treatment - comprises total abdominal hysterectomy, bilateral salpingo-oophorectomy, and peritoneal washings. In some, pelvic and para-aortic lymphadenectomy and omentectomy may be performed. Surgery can be carried out via laparotomy (entry via a transverse or midline incision), or laparoscopy
- stage I – standard approach consists of a total abdominal hysterectomy and bilateral salpingo-oophorectomy with or without lymphadenectomy
- in the UK, pelvic lymphadenectomy is not routinely performed alongside total abdominal hysterectomy and bilateral salpingo-oophorectomy, however in the US, pelvic lymphadenectomy is routinely performed in patients with stage I disease
- stage II - managed with an extended or modified radical hysterectomy, bilateral salpingo-oopherectomy, and systematic pelvic lymphadenectomy with or without para-aortic lymphadenectomy. Lymphadenectomy is used as a guide for surgical staging and adjuvant therapy
- stage III-IV - maximal surgical debulking is recommended in this groups. Palliative surgery could be considered for distant metastasis
- stage I – standard approach consists of a total abdominal hysterectomy and bilateral salpingo-oophorectomy with or without lymphadenectomy
- radiotherapy
- used in the adjuvant setting
- radiotherapy can be delivered as external beam radiotherapy or vaginal brachtherapy
- chemotherapy
- used in the adjuvant setting
- includes carboplatin, doxorubicin, taxol
- progestins are not used in the adjuvant treatment of endometrial cancer (1,2)
Reference:
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