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Surgical Principles in Endometrial Cancer

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Management of Endometrial Cancer

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Abstract

For decades, the standard of treatment for endometrial cancer has been total abdominal hysterectomy with bilateral salpingo-oophorectomy, and the surgical assessment of lymph nodes was reported for the first time in the 1960s [1]. In 1988 the International Federation of Gynecology and Obstetrics (FIGO), following the recommendation of a seminal Gynecologic Oncology Group (GOG) study [2], replaced the clinical staging adopted in 1971 and introduced the concept of surgical staging for endometrial cancer [3]. Comprehensive surgical staging includes hysterectomy, bilateral salpingo-oophorectomy, pelvic and para-aortic lymphadenectomy, and pelvic washing [4]. Pelvic lymphadenectomy consists of the removal of iliac nodes, including common iliac, external iliac, and internal iliac, and obturator lymph nodes. Para-aortic lymphadenectomy consists of the removal of lymph nodes above and below the inferior mesenteric artery, and up to the renal vessels [5]. The current guidelines of the American College of Obstetricians and Gynecologists [4] and the Society of Gynecological Oncology [4] recommend that “the initial management of endometrial cancer should include comprehensive surgical staging.” However, after more than 25 years, the role of lymphadenectomy is still debated and the treatment of endometrial cancer varies largely across practitioners [6–8].

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Authors and Affiliations

  1. Division of Gynecologic Surgery, Department of Obstetrics and Gynecology, Mayo Clinic, Rochester, MN, USA

    Andrea Mariani & Francesco Multinu

  2. Department of Gynecology, IEO, European Institute of Oncology IRCSS, Milan, Italy

    Francesco Multinu

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  1. Andrea Mariani
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  2. Francesco Multinu
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Correspondence to Andrea Mariani .

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  1. Rigshospitalet, Copenhagen University Rigshospitalet, København Ø, Denmark

    Mansoor R. Mirza

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Mariani, A., Multinu, F. (2020). Surgical Principles in Endometrial Cancer. In: Mirza, M. (eds) Management of Endometrial Cancer. Springer, Cham. https://doi.org/10.1007/978-3-319-64513-1_11

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