Adjuvant treatment of intermediate-risk endometrial cancer
- Heidi J Gray, MD
Heidi J Gray, MD
- Associate Professor
- Division of Gynecologic Oncology
- Dept of OB/GYN
- University of Washington
- Wui-Jin Koh, MD
Wui-Jin Koh, MD
- Professor of Radiation Oncology
- Seattle Cancer Care Alliance
- University of Washington School of Medicine
- Section Editors
- Barbara Goff, MD
Barbara Goff, MD
- Section Editor — Gynecologic Oncology
- Professor of Gynecologic Oncology
- University of Washington
- Don S Dizon, MD, FACP
Don S Dizon, MD, FACP
- Section Editor – Gynecologic Oncology
- Clinical Co-Director, Gynecologic Oncology
- Founder and Director, The Oncology Sexual Health Clinic
- Massachusetts General Hospital Cancer Center
- Associate Professor of Medicine
- Harvard Medical School
Cancer of the endometrium is the most common gynecologic malignancy in developed countries and the second most common in developing countries. Endometrioid carcinoma is the most common histologic subtype and typically presents at an early stage with abnormal uterine bleeding. It is associated with a good prognosis. Other histologic types of endometrial carcinoma (eg, serous, clear cell) may not present with uterine bleeding and are typically diagnosed at more advanced stages. As a result, these other types are associated with a poorer prognosis.
The stage at diagnosis (table 1) and histologic subtype of endometrial carcinoma are used to assign risk for recurrent or persistent disease into low-, intermediate-, and high-risk. This review will focus on adjuvant treatment for patients with intermediate-risk endometrial cancer. An overview of endometrial cancer, including clinical features and an approach to diagnosis, an overview on the approach to adjuvant treatment, and treatment of low- and high-risk and advanced endometrial cancer are discussed separately.
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- DEFINITION OF INTERMEDIATE-RISK
- Lower uterine segment involvement
- TREATMENT APPROACH
- Low intermediate-risk
- High intermediate-risk disease
- - Radiation therapy
- Vaginal brachytherapy
- Pelvic radiation
- Intensity modulated radiation therapy
- - Chemotherapy
- - Combined modality treatment
- Unstaged intermediate-risk patients
- POSTTREATMENT SURVEILLANCE
- INFORMATION FOR PATIENTS
- SUMMARY AND RECOMMENDATIONS