[Chemotherapy in metastatic or recurrent endometrial carcinoma]

Endometrial cancer is the fourth most common malignancy in women with an estimated 36,100 new cases diagnosed in the United States. The major treatment is surgical staging with hysterectomy, lymph node assessment and possible adjuvant irradiation. Systemic hormonal and chemotherapy has been reserved for women with disseminated primary disease or extrapelvic recurrence. Recent data showed that oral medroxyprogesterone, 200 mg/day, produced a 25% overall response for patients with well-differentiated histology and positive receptor status. In those patients especially if they are asymptomatic, endocrine therapy may be a reasonable initial approach. Patients with advanced or recurrent endometrial cancer should be considered for clinical trials using new agents or randomized trials designed to answer important questions. For patients not eligible for clinical trials, treatment with a platinum compound and paclitaxel or doxorubicin in combination should be considered.