[Current treatment of endometrial cancer]

The elements of the poor prognosis of endometrial cancer are well known: grade, degree of infiltration of the myometrium, isthmal localization, pelvic and lumboaortic node invasion. But the ways of improving the results are less known: extension of the surgical procedure and the combination surgery-radiotherapy do not improve survival, except in case of grade 3 tumors invading more than half of the myometrium. However, vaginal curietherapy decreases the number of vaginal recurrences. Additional progesterone therapy is the subject of conflicting results. Preventive therapy consists in avoiding exogenous hyper-estrogenias by an adequate prescription of hormone therapy, in an early diagnosis of hyperplasias in risk patients (obesity, dys-ovulation) by a test with progesterone-like substances and endo-uterine smears, and in treating these hyperplasias with a medical treatment, curettage or hysterectomy, according to the circumstances.