No cookie-cutter oncology: individualized treatment approaches for women with corpus endometrial cancer.
Endometrial adenocarcinoma is the most common gynecologic malignancy and, for the majority of patients who present with stage I (approximately 70%) or stage II ( approximately 10%) disease, 5-year overall survival rates approach 85%. However, the complicated mix of medical comorbidities, the broad spectrum of techniques and treatment modalities and controversial clinical trial outcomes makes treating this heterogeneous group of patients unique and challenging. Similar management controversies exist and, when one factors in histologic variability, no flow-chart treatment algorithm can be easily constructed. This article will discuss data from key clinical trials, consider the role of routine lymphadenectomy as a component of surgical staging, discuss the heterogeneity of stage III patients in both presentation and response to treatment, review options for medically inoperable patients and reflect on current and upcoming protocols.
Feddock
Jonathan
J
Department of Radiation Medicine, University of Kentucky Chandler Medical Center and Markey Cancer Center, Lexington, KY, USA. jmfedd0@uky.edu
Kudrimoti
Mahesh
M
Randall
Marc
M
D000230:Adenocarcinoma / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000473:pathology / Q000601:surgery / Q000628:therapy*; D000368:Aged; D000465:Algorithms; D018931:Antineoplastic Agents, Hormonal / Q000627:therapeutic use; D001918:Brachytherapy; D002584:Cervix Uteri / Q000473:pathology; D017326:Clinical Trials, Phase III as Topic; D003131:Combined Modality Therapy; D015897:Comorbidity; D003657:Decision Making; D016889:Endometrial Neoplasms / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000473:pathology / Q000601:surgery / Q000628:therapy*; D005260:Female; D006801:Humans; D007044:Hysterectomy; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D057285:Precision Medicine; D011859:Radiography; D018714:Radiotherapy, Adjuvant; D016032:Randomized Controlled Trials as Topic; D012306:Risk
D018931:Antineoplastic Agents, Hormonal