Management of endometrial carcinoma with cervical involvement. An unsettled issue

The purpose of the present report is to review the various management options of endometrial carcinoma with cervical involvement. A Medline literature search for publications dealing with endometrial carcinoma (EC) with cervical involvement and treatment was made. Although many publications deal with EC with cervical involvement there is a lack of prospective controlled trials. Only one prospective randomized phase III trial has been published. The inaccuracies of clinical staging, the scarcity of reports with surgically staged patients, the multiple types of cervical involvement and prognostic indicators and the remarkable variations in treatment render it difficult to compare outcome results between publications. The small number of patients in many of these studies and their retrospective uncontrolled nature add to this difficulty. There are conflicting reports with regard to factors affecting outcome, also complicating the management issue of endometrial carcinoma with cervical involvement and comparison of treatment results. The optimal management of EC with cervical involvement remains to be established.