The role of surgery in recurrent endometrial cancer.
BACKGROUND
Endometrial cancer is a common gynecologic malignancy in the United States, and the recurrence rate depends on the disease stage at diagnosis. Recurrence can affect several areas and follow different patterns.


METHODS
The role of surgery at the time of recurrence is not clearly defined. In this review, we fully describe the current evidence available. In particular, we describe how surgical treatment might be recommended for 1) vaginal or pelvic recurrences; 2) retroperitoneal or localized intra-abdominal recurrence, when a maximal cytoreductive effort is more likely to be successful; or 3) isolated distant recurrences when microscopically tumor-free margins can be achieved. Expert commentary: Cases should be evaluated individually, considering factors such as comorbidities, risks of intervention, and impact of treatment on quality of life.
a Division of Gynecologic Surgery , Mayo Clinic , Rochester , MN , USA.
Valentina
V
Zanfagnin
b Academic Division of Obstetrics and Gynecology , Mauriziano Umberto I Hospital , Turin , Italy.
Annamaria
A
Ferrero
b Academic Division of Obstetrics and Gynecology , Mauriziano Umberto I Hospital , Turin , Italy.
Nicoletta
N
Biglia
c European Institute of Oncology , Milan , Italy.
Giovanni
G
Aletti
a Division of Gynecologic Surgery , Mayo Clinic , Rochester , MN , USA.
Sarah E
SE
Gill
a Division of Gynecologic Surgery , Mayo Clinic , Rochester , MN , USA.
Peter B
PB
Makdisi
a Division of Gynecologic Surgery , Mayo Clinic , Rochester , MN , USA.
Francesco
F
Multinu
a Division of Gynecologic Surgery , Mayo Clinic , Rochester , MN , USA.
Andrea
A
Mariani
D065426:Cytoreduction Surgical Procedures / Q000379:methods*; D016889:Endometrial Neoplasms / Q000453:epidemiology / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging; D011788:Quality of Life; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology
Endometrial neoplasm; intraoperative radiation therapy; metastases; quality of life; secondary cytoreductive surgery