Current Treatment Approach of Endometrial Cancer - Special Issue

Systematic surgical staging is the primary treatment, for most patients with endometrial cancer and includes: total hysterectomy, bilateral salpingo-oophorectomy, pelvic and para-aortic lymphadenectomy and complete resection of all disease. Especially in patients with type II endometrial cancer, systematic surgical staging includes additional omentectomy, appendectomy and biopsy of any suspected lesion. Although pelvic washings are no longer part of FIGO surgical staging system for endometrial cancer, they should be reported separately. Especially in endometrial cancer patients with increased risk for recurrence or at advanced stage disease, it is necessary a more aggressive treatment approach with postoperative adjuvant radiotherapy and/or chemotherapy. Postoperative adjuvant radiotherapy in endometrial cancer patients includes vaginal brachytherapy and external radiotherapy. Vaginal brachytherapy is the adjuvant treatment of choice for intermediate risk endometrial cancer patients. External pelvic radiotherapy is the adjuvant treatment of choice only in high risk endometrial cancer patients. Postoperative adjuvant chemotherapy has very important role for endometrial cancer patients with advanced stage disease. The combination of adjuvant chemotherapy and radiotherapy is promising in high risk endometrial cancer patients or in endometrial cancer patients at advanced stage disease. Molecular targeted therapies have only modest effect in unselected endometrial cancer patients. Especially the role of ErbBtargeted therapies in selected EC patients, should be further investigated.