Date: 26 Aug 2009

Special cases in endometrial cancer

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Surgery is the mainstay of treatment for patients with endometrial cancer. This includes hysterectomy, bilateral salpingo-oophorectomy, assessment of peritoneal cytology, and pelvic and para-aortic lymphadenectomy in patients at risk of lymphatic metastases. However, 25% of women with EC are premenopausal and 5% are under the age of 40 [1]. In this cohort of women, ovarian and uterine preservation are frequently considered. Furthermore, these women are at higher risk of harboring germline mutations responsible for the early onset of endometrial cancer. Presumably, a subset of these women would benefit from genetic screening, screening for associated malignancies, and even prophylactic surgery in the event that a mutation is detected. In this review, we discuss these difficult considerations. Optimal management of these patients continues to evolve and in some situations management recommendations are based on incomplete data.

Ovarian preservation and estrogen replacement in ...