Adjuvant chemotherapy for high-risk endometrial cancer

Identification of histopathologic factors that predict the risk of tumor recurrence allows for selection of women with endometrial cancer who might benefit from adjuvant therapy. Most studies of adjuvant treatment have focused on external-beam irradiation or oral progestational agents and have failed to document a survival advantage for treated patients. Although recurrent or metastatic endometrial tumors often respond to salvage treatment with cytotoxic agents, there is relatively little experience with postoperative systemic chemotherapy used in an adjuvant setting. A few nonrandomized trials-using doxorubicin/platinum-based regimens-have suggested that adjuvant chemotherapy may be beneficial in some patient subsets. Data from larger-scale, randomized trials do not exist. Additional clinical experience is needed before a definite role for adjuvant chemotherapy can be established.