Total abdominal hysterectomy and bilateral salpingo-oophorectomy constitute both the staging procedure and the treatment of choice. The staging scheme and its influence on prognosis are shown in Table 73-1. About 75% of pts are stage I, 13% are stage II, 9% are stage III, and 3% are stage IV.
Treatment: Endometrial Cancer In women with poor histologic grade, deep myometrial invasion, or extensive involvement of the lower uterine segment or cervix, intracavitary or external-beam radiation therapy is given. If cervical invasion is deep, preoperative radiation therapy may improve the resectability of the tumor. Stage III disease is managed with surgery and radiation therapy. Stage IV disease is usually treated palliatively. Progestational agents such as hydroxyprogesterone or megestrol and the antiestrogen tamoxifen may produce responses in 20% of pts. Doxorubicin, 60 mg/m2 IV day 1, and cisplatin, 50 mg/m2 IV day 1, every 3 weeks for 8 cycles produces a 45% response rate. |
Section 6. Hematology and Oncology