The current status of surgery for endometrial carcinoma: facts and fantasy

Surgery is the prime method of therapy for endometrial carcinoma. However, in nearly all cases radiotherapy is combined with it either before or after operation. High risk factors include hyperoestrinism, cervical spread, myometrial invasion, cellular anaplasia, and metastatic spread to adnexa, vagina and the pelvic lymph nodes. The latter involvement of the last factor is analysed in some detail, on the base of 216 dissections with an incidence of 8%. Analysis of other authors' findings are reviewed on the basis of autopsy and selection. The place for Wertheim hysterectomy is discussed, also vaginal hysterectomy and the timing of surgery when irradiation is given preoperatively. The author's statistics are derived from a previous study of 468 patients treated between 1956 and 1971.