Endometrial, Ovarian, and Cervical Cancer
CARCINOMA OF THE ENDOMETRIUM
Treatment
Treatment is based on the surgically determined disease stage and on assessment of prognostic features.1 Staging of endometrial cancer is defined by the International Federation of Gynecology and Obstetrics (FIGO) criteria outlined in Table 1. Surgical staging by exploratory laparotomy requires a peritoneal cytology assessment, intraoperative inspection of the abdominal and pelvic organs (diaphragm, liver, omentum, pelvic and aortic lymph nodes, peritoneal surfaces) for evaluation of metastatic disease, hysterectomy with bilateral salpingo-oophorectomy, and retroperitoneal lymph node sampling.2
Table 1 FIGO Staging for Endometrial Carcinoma
Stage | Definition |
---|---|
I | Carcinoma confined to the corpus uteri |
II | Carcinoma that involves the corpus and the cervix but has not extended outside the uterus |
III | Carcinoma that extends outside the uterus but is confined to the true pelvis and/or retroperitoneal lymph nodes |
IV | Carcinoma that involves the bladder or bowel mucosa or that has metastasized to distant sites |
FIGO, International Federation of Gynecology and Obstetrics.
Adjuvant Treatment
The need for adjuvant therapy is based on disease stage and on risk factors for tumor recurrence.
Stage II Disease
Outcomes
Endometrial cancer is one of the most curable of the gynecologic cancers because most patients have well-differentiated tumors and present with symptoms early in the disease process (Table 2). Five-year survival rates are much poorer in patients with the less common and poorly differentiated tumor histologies. These patients often present with metastatic disease and account for a disproportionate number of endometrial cancer deaths.
Table 2 Endometrial Carcinoma: Stage at Presentation and 5-year Relative Survival Rate
Disease Extent | Stage Distribution (%) | Survival (%) |
---|---|---|
All stages | — | 84 |
Localized | 73 | 96 |
Regional | 13 | 66 |
Distant | 9 | 27 |
Unstaged | 4 | 53 |
Adapted from Ries LAG, Kosary CL, Hankey BF, et al (eds): SEER Cancer Statistics Review, 1973-1995. Bethesda, National Cancer Institute, 1998.