Skip to main content

Advertisement

SpringerLink
Log in

Endometrial carcinoma

  • Published:
Current Treatment Options in Oncology Aims and scope Submit manuscript

Opinion statement

Endometrial cancer is a common tumor of the female genital tract. The majority of women diagnosed with endometrial cancer present with early-stage disease. Although the optimal treatment for these patients requires hysterectomy, the use of lymphadenectomy is controversial. Growing scientific data support the use of lymphadenectomy in all patients diagnosed with endometrial cancer. When performed by an experienced surgeon, pelvic and para-aortic lymphadenectomy is a safe and potentially therapeutic procedure that provides prognostic information to the patient and physician. This information allows appropriate, cost-effective treatment strategies to be created for all women with endometrial cancer.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Subscribe and save

Springer+ Basic
$34.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or eBook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References and Recommended Reading

  1. Greenlee RT, Murray T, Bolden S, et al.: Cancer statistics, 2000. CA Cancer J Clin 2000, 50:7–33.

    Article  PubMed  CAS  Google Scholar 

  2. Corn BW: Intermediate-risk endometrial cancer. A management approach. Am J Clin Oncol 1996, 19:631–635.

    Article  PubMed  CAS  Google Scholar 

  3. Weiss MF, Connell PP, Waggoner S, et al.: External pelvic radiation therapy in stage IC endometrial carcinoma. Obstet Gynecol 1999, 93:599–602.

    Article  PubMed  CAS  Google Scholar 

  4. Aalders J, Abeler V, Kolstad P, et al.: Postoperative external irradiation and prognostic parameters in stage I endometrial carcinoma: clinical and histopathologic study of 540 patients. Obstet Gynecol 1980, 56:419–427.

    PubMed  CAS  Google Scholar 

  5. Creutzberg CL, van Putten WL, Koper PC, et al.: Surgery and postoperative radiotherapy versus surgery alone for patients with stage-1 endometrial carcinoma: multicentre randomised trial. PORTEC Study Group. Post operative radiation therapy in endometrial carcinoma. Lancet 2000, 355:1404–1411. A large prospective trial showing no survival benefit from postoperative radiation therapy in endometrial cancer patients.

    Article  PubMed  CAS  Google Scholar 

  6. Boronow RC: Surgical staging of endometrial cancer: evolution, evaluation, and responsible challenge—a personal perspective. Gynecol Oncol 1997, 66:179–189.

    Article  PubMed  CAS  Google Scholar 

  7. Creasman WT, Morrow CP, Bundy BN, et al.: Surgical pathologic spread patterns of endometrial cancer. A Gynecologic Oncology Group Study. Cancer 1987, 60:2035–2041.

    Article  PubMed  CAS  Google Scholar 

  8. Orr Jr JW, Orr PF, Taylor PT: Surgical staging endometrial cancer. Clin Obstet Gynecol 1996, 39:656–668.

    Article  PubMed  Google Scholar 

  9. Cowles TA, Magrina JF, Masterson BJ, et al.: Comparison of clinical and surgical-staging in patients with endometrial carcinoma. Obstet Gynecol 1985, 66:413–416.

    PubMed  CAS  Google Scholar 

  10. Creasman WT, DeGeest K, DiSaia PJ, et al.: Significance of true surgical pathologic staging: a Gynecologic Oncology Group Study. Am J Obstet Gynecol 1999, 181:31–34.

    Article  PubMed  CAS  Google Scholar 

  11. Wolfson AH, Sightler SE, Markoe AM, et al.: The prognostic significance of surgical staging for carcinoma of the endometrium. Gynecol Oncol 1992, 45:142–146.

    Article  PubMed  CAS  Google Scholar 

  12. Belinson JL, Lee KR, Badger GJ, et al.: Clinical stage I adenocarcinoma of the endometrium—analysis of recurrences and the potential benefit of staging lymphadenectomy. Gynecol Oncol 1992, 44:17–23.

    Article  PubMed  CAS  Google Scholar 

  13. Petereit DG: Complete surgical staging in endometrial cancer provides prognostic information only. Semin Radiat Oncol 2000, 10:8–14.

    Article  PubMed  CAS  Google Scholar 

  14. Barnes MN, Kilgore LC: Complete surgical staging of early endometrial adenocarcinoma: optimizing patient outcomes. Semin Radiat Oncol 2000, 10:3–7.

    Article  PubMed  CAS  Google Scholar 

  15. Fanning J, Nanavati PJ, Hilgers RD: Surgical staging and high dose rate brachytherapy for endometrial cancer: limiting external radiotherapy to nodepositive tumors. Obstet Gynecol 1996, 87:1041–1044.

    Article  PubMed  CAS  Google Scholar 

  16. Chen SS: Operative treatment in stage I endometrial carcinoma with deep myometrial invasion and/or grade 3 tumor surgically limited to the corpus uteri. No recurrence with only primary surgery. Cancer 1989, 63:1843–1845.

    Article  PubMed  CAS  Google Scholar 

  17. Naumann RW, Higgins RV, Hall JB: The use of adjuvant radiation therapy by members of the Society of Gynecologic Oncologists. Gynecol Oncol 1999, 75:4–9.

    Article  PubMed  CAS  Google Scholar 

  18. Gretz HF, Economos K, Husain A, et al.: The practice of surgical staging and its impact on adjuvant treatment recommendations in patients with stage I endometrial carcinoma. Gynecol Oncol 1996, 61:409–415.

    Article  Google Scholar 

  19. Chuang L, Burke TW, Tornos C, et al.: Staging laparotomy for endometrial carcinoma: assessment of retroperitoneal lymph nodes. Gynecol Oncol 1995, 58:189–193.

    Article  PubMed  CAS  Google Scholar 

  20. Arango HA, Hoffman MS, Roberts WS, et al.: Accuracy of lymph node palpation to determine need for lymphadenectomy in gynecologic malignancies. Gynecol Oncol 2000, 95:553–556.

    CAS  Google Scholar 

  21. Girardi F, Petru E, Heydarfadai M, et al.: Pelvic lymphadenectomy in the surgical treatment of endometrial cancer. Gynecol Oncol 1993, 49:177–180.

    Article  PubMed  CAS  Google Scholar 

  22. Daniel AG, Peters WA: Accuracy of office and operating room curettage in the grading of endometrial carcinoma. Obstet Gynecol 1988, 71:612–614.

    PubMed  CAS  Google Scholar 

  23. Larson DM, Johnson KK, Broste SK, et al.: Comparison of D&C and office endometrial biopsy in predicting final histopathologic grade in endometrial cancer. Obstet Gynecol 1995, 86:38–42.

    Article  PubMed  CAS  Google Scholar 

  24. Kim YB, Niloff JM: Endometrial carcinoma: analysis of recurrence in patients treated with a strategy minimizing lymph node sampling and radiation therapy. Obstet Gynecol 1993, 82:175–180.

    PubMed  CAS  Google Scholar 

  25. Goff BA, Rice LW: Assessment of depth of myometrial invasion in endometrial adenocarcinoma. Gynecol Oncol 1990, 38:46–48.

    Article  PubMed  CAS  Google Scholar 

  26. Zorlu CG, Kuscu E, Ergun Y, et al.: Intraoperative evaluation of prognostic factors in stage I endometrial cancer by frozen section: how reliable? Acta Obstet Gynecol Scand 1993, 72:382–385.

    PubMed  CAS  Google Scholar 

  27. Orr Jr JW, Holimon JL, Orr PF: Stage I corpus cancer: is teletherapy necessary? Am J Obstet Gynecol 1997, 176:777–788. A large study of endometrial cancer patients demonstrating low morbidity with lymphadenectomy.

    Article  PubMed  Google Scholar 

  28. Mohan DS, Samuels MA, Selim MA, et al.: Long-term outcomes of therapeutic pelvic lymphadenectomy for stage I endometrial adenocarcinoma. Gynecol Oncol 1998, 70:165–171.

    Article  PubMed  CAS  Google Scholar 

  29. Kilgore LC, Partridge EE, Alvarez RD, et al.: Adenocarcinoma of the endometrium: survival comparisons of patients with and without pelvic node sampling. Gynecol Oncol 1995, 56:29–33. A retrospective review of endometrial cancer patients demonstrating a therapeutic benefit with lymphadenectomy.

    Article  Google Scholar 

  30. Mariani A, Webb MJ, Galli L, et al.: Potential therapeutic role of para-aortic lymphadenectomy in node-positive endometrial cancer. Gynecol Oncol 2000, 76:348–356.

    Article  PubMed  CAS  Google Scholar 

  31. Homesley HD, Kadar N, Barrett RJ, et al.: Selective pelvic and periaortic lymphadenectomy does not increase morbidity in surgical staging of endometrial carcinoma. Am J Obstet Gynecol 1992, 167:1225–1230.

    PubMed  CAS  Google Scholar 

  32. Larson DM, Johnson K, Olson KA: Pelvic and paraaortic lymphadenectomy for surgical staging of endometrial cancer: morbidity and mortality. Obstet Gynecol 1992, 79:998–1001.

    PubMed  CAS  Google Scholar 

  33. Larson DM, Johnson KK: Pelvic and para-aortic lymphadenectomy for surgical staging of high-risk endometrioid adenocarcinoma of the endometrium. Gynecol Oncol 1993, 51:345–348.

    Article  PubMed  CAS  Google Scholar 

  34. Orr JW: Surgical staging of endometrial cancer: does the patient benefit? Gynecol Oncol 1998, 71:335–339.

    Article  PubMed  CAS  Google Scholar 

  35. Partridge EE, Jessup JM, Donaldson ES, et al.: 1996 patient care evaluation study (PCE) of cancer of the corpus uteri, National Cancer Database (NCDB), American College of Surgery. Gynecol Oncol 1999, 72:444.

    Google Scholar 

  36. Corn BW, Lanciano RM, Greven KM, et al.: Impact of improved irradiation technique, age, and lymph node sampling on the severe complication rate of surgically staged endometrial cancer patients: a multivariate analysis. J Clin Oncol 1994, 12:510–515.

    PubMed  CAS  Google Scholar 

  37. Moore DH, Fowler Jr WC, Walton LA, et al.: Morbidity of lymph node sampling in cancers of the uterine corpus and cervix. Obstet Gynecol 1989, 74:180–184.

    PubMed  CAS  Google Scholar 

  38. Ashih H, Gustilo-Ashby T, Myers ER, et al.: Costeffectiveness of treatment of early stage endometrial cancer. Gynecol Oncol 1999, 74:208–216.

    Article  PubMed  CAS  Google Scholar 

  39. Fanning J: Treatment for early endometrial cancer. Cost-effectiveness analysis. J Reprod Med 1999, 44:719–723.

    PubMed  CAS  Google Scholar 

  40. Barnes MN, Roland PY, Straughn M, et al.: A comparison of treatment strategies for endometrial adenocarcinoma: analysis of financial impact. Gynecol Oncol 1999, 74:443–447. A cost analysis evaluating the cost effectiveness of surgical staging and adjuvant radiation in endometrial cancer patients.

    Article  Google Scholar 

  41. Konski AA, Bracy PM, Jurs SG, et al.: Cost minimization analysis of various treatment options for surgical stage I endometrial carcinoma. Int J Radiat Oncol Biol Phys 1997, 37:367–373.

    Article  PubMed  CAS  Google Scholar 

  42. Straughn JM, Stringer J, Barnes MN, et al.: Choosing the appropriate treatment for endometrial adenocarcinoma: a cost-effectiveness analysis. Gynecol Oncol 2000, 76:251.

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Alabama at Birmingham, 619 19th Street South, OHB Room 538, 35249, Birmingham, AL, USA

    Warner K. Huh MD, J. Michael Straughn MD, F. Joseph Kelly MD & Larry C. Kilgore MD

Authors
  1. Warner K. Huh MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. J. Michael Straughn MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. F. Joseph Kelly MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Larry C. Kilgore MD
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Huh, W.K., Straughn, J.M., Kelly, F.J. et al. Endometrial carcinoma. Curr. Treat. Options in Oncol. 2, 129–135 (2001). https://doi.org/10.1007/s11864-001-0055-z

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11864-001-0055-z

Keywords

Search

Navigation