Treatment modalities in endometrial cancer

Endometrial cancer is the most common malignancy of the female genital tract. This review highlights new insights and these will change current practice.

Surgery is the cornerstone of the treatment of endometrial cancer but the metastatic pattern is different for types 1 and 2. The surgical staging procedure therefore depends on subtype. Type 2 endometrial cancers often metastasize to the lymph nodes and peritoneal cavity and patients should undergo a staging procedure similar to that performed for ovarian cancer. Laparoscopic staging and treatment for endometrial cancer appears to be safe and effective. Adequate staging also serves to appropriately tailor adjuvant treatment modalities that benefit high-risk patients only. Recent data suggest adequate staging to improve the overall survival. In addition, following complete surgical staging, recent studies emphasize the benefit for adjuvant chemotherapy in early stage serous endometrial cancer. Adjuvant chemotherapy appears to be more effective than radiotherapy for type 1 cancers. In the primarily advanced or recurrent setting, hormonal treatment may be beneficial. Doxorubicin-cisplatin is still the standard chemotherapy regime used in many centres; paclitaxel-containing regimes also appear to show promise.

Recent data shed new light on the current concepts of tumour spread, surgical staging and adjuvant treatment modalities for endometrial cancer.