The surgical treatment in the early disease

Andrea Tinelli, Giorgio Giorda, Sarah Gustapane, Roberta Montefrancesco, Marilena Greco, Daniele Vergara, Michele Maffia, Marianna Giampaglia, Vito Lorusso, Antonio Malvasi

Research output: Chapter in Book/Report/Conference proceedingChapter

Abstract

Each year endometrial cancer affects lots of women in industrialized societies. The diagnosis of endometrial carcinoma requires histopathological confirmation. This diagnosis is made according to the World Health Organisation (WHO) pathological classification. About 80% of endometrial carcinomas are of endometrioid type. Endometrial carcinoma is a surgically staged disease. Operation is the therapy of choice in the primary treatment of patients with endometrial cancer. The type of surgery and postoperative therapy depends on the stage and other clinical-pathological risk factors. The traditional abdominal approach, vaginal, laparoscopic and robotic-assisted methods are available for the surgical treatment of endometrial cancer. This chapter discusses these different treatment options. With a rising incidence of obesity, number of patients with endometrial cancer will also increase. However, operations in obese patients are more challenging. Laparotomy as a standard therapy in endometrial cancer patients stage I and II should be replaced by laparoscopic approaches. Laparoscopy is oncologically adequate to open procedures and offers many advantages to patients. Robotic surgery in the treatment of endometrial cancer is still under evaluation. Most controversial points of treatment today are an indication and an extension of lymphadenectomy in different stages. Most recurrences will occur within the first 3 years after treatment and 3- to 4-montly evaluations with history. Physical and gynecological examination are usually recommended. Follow-up intervals of 6 months are recommended during the fourth and fifth years, and annually thereafter. No impact on survival of a routine follow-up strategy has been demonstrated.

Original languageEnglish
Title of host publicationEndometrial Cancer: Prevention, Diagnosis and Treatment
PublisherNova Science Publishers, Inc.
Pages73-108
Number of pages36
ISBN (Print)9781622577408
Publication statusPublished - Feb 2013

ASJC Scopus subject areas

  • Biochemistry, Genetics and Molecular Biology(all)
  • Medicine(all)

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