Onkológia 4/2021

Surgery treatment of endometrial cancer

Endometrial cancer is the most common malignancy of the female reproductive tract. It is generally regarded as a malignant tumor with good prognosis. Management of patients with endometrial cancer has always been, and probably will continue to be, somewhat different based on country and cancer center. Hysteroscopy is now considered to be the gold standard for diagnosis of intrauterine pathology and should always be preferred to curettage. Main prognostic factors are stage, histopathologic type, tumor grade and molecular markers. Treatment of endometrial cancer is local, regional or systemic. Surgery is an essential therapeutic modality in current management of endometrial cancer. The issue of adequate surgical staging is currently (and probably will remain for some time) a controversial topic. Pelvic and paraaortic lymphadenectomy can still be a part of surgical staging. Hotly debated issue is maximizing benefit of lymphadenectomy in terms of patient survival and provision of useful information for adjuvant treatment. Sentinel node biopsy in endometrial cancer is now accepted worldwide. Despite the vast amount of published surgical data on endometrial cancer, risk of “understaging” versus “overtreating” still remains.

Keywords: endometrial cancer, lymphadenectomy, surgery, staging, sentinel node