[Endometrial cancer]

The current treatment of choice for endometrial cancer is reported to be primary surgery including a total abdominal hysterectomy, bilateral salpingo-oophorectomy, peritoneal cytologic sampling, and exploration, palpation, and biopsy of any suspicious lymph nodes or lesions. This allows determination of the extent of the disease, the stage of malignancy and the risk of recurrence. Adjuvant radiation therapy is administered to the pelvis for intermediate-risk patients, and a systemic chemotherapy is considered for high-risk ones, while no treatment is added for low-risk patients. But for patients with the malignancy, many Japanese gynecologists have performed extended hysterectomy instead of total hysterectomy to reduce the incidence of vaginal recurrence, achieved the pelvic and para-aortic lymphadenectomy as a substitute for biopsy sampling to avoid recurrence in lymph nodes, and given cytotoxic chemotherapy in place of irradiation to prevent radiation morbidity and recurrence at a distant site. Although differences in treatments for advanced disease have disappeared, further efforts are recommended to find useful prognostic factors for distinguishing patients with poorer prognoses, and to establish a standard treatment for endometrial cancer all over the world.