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Treatment

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

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Consult expert advice.

Treatment options for endometrial cancer include:

  • surgical treatment - comprises total abdominal hysterectomy, bilateral salpingo-oophorectomy, and peritoneal washings. In some, pelvic and para-aortic lymphadenectomy and omentectomy may be performed. Surgery can be carried out via laparotomy (entry via a transverse or midline incision), or laparoscopy
    • stage I – standard approach consists of a total abdominal hysterectomy and bilateral salpingo-oophorectomy with or without lymphadenectomy
      • in the UK, pelvic lymphadenectomy is not routinely performed alongside total abdominal hysterectomy and bilateral salpingo-oophorectomy, however in the US, pelvic lymphadenectomy is routinely performed in patients with stage I disease
    • stage II - managed with an extended or modified radical hysterectomy, bilateral salpingo-oopherectomy, and systematic pelvic lymphadenectomy with or without para-aortic lymphadenectomy. Lymphadenectomy is used as a guide for surgical staging and adjuvant therapy
    • stage III-IV - maximal surgical debulking is recommended in this groups. Palliative surgery could be considered for distant metastasis
  • radiotherapy
    • used in the adjuvant setting
    • radiotherapy can be delivered as external beam radiotherapy or vaginal brachtherapy
  • chemotherapy
    • used in the adjuvant setting
    • includes carboplatin, doxorubicin, taxol
    • progestins are not used in the adjuvant treatment of endometrial cancer (1,2)

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