January 2003 · Vol. 15, No. 1Current management of early-stage endometrial cancer
Endometrial cancer remains the most common malignancy of the female gynecologic tract. Here, an expert outlines the management of early-stage disease, including surgical staging, and explores the role of adjuvant radiation therapy, lymph-node sampling, and laparoscopy.
RICHARD
R.
BARAKAT,
MDDr. Barakat is chief, gynecology service, Memorial Sloan-Kettering Cancer Center, New York City.
|
KEY POINTS
-
Comprehensive surgical staging is an integral part of treatment of early-stage endometrial cancer.
-
Standard surgical staging includes exploratory laparotomy, complete inspection of the abdomen and pelvis, biopsies of suspicious areas, total abdominal hysterectomy, bilateral salpingo-oophorectomy, and lymph-node sampling.
-
The extent of lymph-node sampling, the appropriate adjuvant therapy, and the use of laparoscopy are the major areas of controversy in the management of early-stage endometrial cancer.
-
Concerns that hormone replacement therapy may increase the likelihood of endometrial cancer recurrence have not yet been adequately explored by randomized trials.
|
 |
Approximately 39,300 new cases of endometrial cancer were diagnosed in 2002, and the disease is the sixth most common cause of cancer deaths in women. While the mortality rate has declined by more than half since 1940, the disease still caused an estimated 6,600 deaths in 2002. The lifetime risk of being diagnosed with endometrial cancer is approximately 2.7%, and the median age at diagnosis is 65 years. Almost three quarters of cases are diagnosed before the disease has spread outside the uterus. The overall 5-year survival rate for all stages of endometrial cancer is 86%, with disease confined to the uterus having a 97% 5-year survival rate.1
|
