Current issues in the management of endometrial cancer

Jamie N. Bakkum-Gamez, Jesus Gonzalez-Bosquet, Nadia N. Laack, Andrea Mariani, Sean C. Dowdy

Research output: Contribution to journalArticlepeer-review

108 Scopus citations

Abstract

Endometrial cancer (EC) remains the most common gynecologic malignancy in the United States. It is expected to become more common as the prevalence of obesity, one of the most common risk factors for EC, increases worldwide. The 2 main histologic subcategories of EC, endometrioid and nonendometrioid EC, show unique molecular aberrations and are responsible for markedly disparate clinical behaviors. The primary treatment of EC is surgery, ie, hysterectomy, removal of the adnexa, and pelvic and para-aortic lymphadenectomy, either via laparotomy or endoscopic techniques. Adjuvant therapy is necessary for patients at high risk of recurrence and consists of vaginal brachytherapy, teletherapy, systemic chemotherapy, or some combination thereof. Multi-institutional trials are in progress in this country and in Europe to better define optimal adjuvant treatment for subsets of patients, as well as the role of surgical staging in reducing both overuse and underuse of radiation therapy. Hormonal therapy is an option for some young women with EC who wish to preserve fertility. This review summarizes the diagnosis and management of EC and discusses current controversies and upcoming investigations pertaining to EC staging and adjuvant treatment.

Original languageEnglish (US)
Pages (from-to)97-112
Number of pages16
JournalMayo Clinic proceedings
Volume83
Issue number1
DOIs
StatePublished - Jan 2008

ASJC Scopus subject areas

  • Medicine(all)

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