Endometrial cancer.
Endometrial cancer is the most common gynaecological tumour in developed countries, and its incidence is increasing. The most frequently occurring histological subtype is endometrioid adenocarcinoma. Patients are often diagnosed when the disease is still confined to the uterus. Standard treatment consists of primary hysterectomy and bilateral salpingo-oophorectomy, often using minimally invasive approaches (laparoscopic or robotic). Lymph node surgical strategy is contingent on histological factors (subtype, tumour grade, involvement of lymphovascular space), disease stage (including myometrial invasion), patients' characteristics (age and comorbidities), and national and international guidelines. Adjuvant treatment is tailored according to histology and stage. Various classifications are used to assess the risks of recurrence and to determine optimum postoperative management. 5 year overall survival ranges from 74% to 91% in patients without metastatic disease. Trials are ongoing in patients at high risk of recurrence (including chemotherapy, chemoradiation therapy, and molecular targeted therapies) to assess the modalities that best balance optimisation of survival with the lowest adverse effects on quality of life.
Department of Gynecologic Surgery, Gustave Roussy, Villejuif, France; Unit INSERM U 1030, Gustave Roussy, Villejuif, France; Université Paris-Sud (Paris XI), Le Kremlin Bicêtre, France. Electronic address: philippe.morice@gustaveroussy.fr.
Philippe
P
Morice
Department of Medical Oncology, Gustave Roussy, Villejuif, France; Translational Research Lab U981, Gustave Roussy, Villejuif, France.
Alexandra
A
Leary
Department of Radiation Oncology, Leiden University Medical Center, Leiden, Netherlands.
Carien
C
Creutzberg
Memorial Sloan-Kettering Cancer Center, New York, NY, USA.
Nadeem
N
Abu-Rustum
Department of Obstetrics and Gynaecology, Hôpital Tenon, Paris, France; INSERM UMRS 938, Paris, France; Université Pierre et Marie Curie (Paris VI), Paris, France.
Emile
E
Darai
D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use; D003131:Combined Modality Therapy; D055088:Early Detection of Cancer; D016889:Endometrial Neoplasms / Q000453:epidemiology / Q000473:pathology / Q000628:therapy*; D005260:Female; D005817:Genetic Counseling / Q000379:methods; D006801:Humans; D008197:Lymph Node Excision / Q000379:methods; D008875:Middle Aged; D058990:Molecular Targeted Therapy / Q000379:methods; D009154:Mutation / Q000235:genetics; D020360:Neoadjuvant Therapy; D009361:Neoplasm Invasiveness; D009362:Neoplasm Metastasis; D009364:Neoplasm Recurrence, Local / Q000628:therapy; D009367:Neoplasm Staging; D011300:Preoperative Care / Q000379:methods; D011379:Prognosis; D012307:Risk Factors; D016019:Survival Analysis; D014592:Uterine Hemorrhage / Q000209:etiology
D000970:Antineoplastic Agents