Surgery for endometrial cancer: what type and by whom?

Endometrial cancer has far too long been regarded as a simple disease to treat. As such it has generally remained in the hands of the generalist obstetrician/gynaecologist. In order to optimize the choice of surgery, careful pre-operative evaluation is essential with respect to pathology of a biopsy, radiological assessment of extent of disease and evaluation of fitness for anaesthesia. The standard procedure is a total abdominal hysterectomy and bilateral salpingo-oophorectomy. However, consideration should be given to pelvic lymphadenectomy in high-risk cases. Surgery for high-risk endometrial cancer should be performed by gynaecological oncologists.