Affiliation:
1. Department of Obstetrics and Gynecology, Tohoku University Graduate School of Medicine, Miyagi, Japan
2. Department of Gynecology, National Cancer Center Hospital, Tokyo, Japan
Abstract
Abstract
Objective
The mainstay of treatment for uterine endometrial cancer is surgery, and recurrent-risk cases require multidisciplinary treatment, including surgery, chemotherapy and radiation therapy.
Methods
The standard surgery for uterine endometrial cancer is hysterectomy and bilateral salpingooophorectomy, with additional retroperitoneal lymph node dissection and omentectomy, depending on the case. The appropriate treatment is determined based on the risk classification, such as the depth of invasion into the myometrium, diagnosis of histological type and grade, and risk assessment of lymph node metastasis.
Results
Recently, minimally invasive surgery has been widely used not only in low-risk patients but also in intermediate- and high-risk patients. In low-risk patients, the possibility of ovarian preservation is discussed from a healthcare perspective for young women. Determining the need for retroperitoneal lymph node dissection based on sentinel lymph node evaluation may contribute in minimizing the incidence of post-operative lymphedema while ensuring accurate diagnosis of lymph node metastasis. Recently, many studies using sentinel lymph nodes have been reported for patients with uterine endometrial cancer, and the feasibility of sentinel lymph node mapping surgery has been proven. Unfortunately, sentinel lymph node biopsy and sentinel lymph node mapping surgery have not been widely adopted in surgery for uterine cancer in Japan. In addition, the search for biomarkers, such as RNA sequencing using The Cancer Genome Atlas, metabolic profile and lipidomic profile for early detection and prognostic evaluation, has been actively pursued.
Conclusions
Gynecologic oncologists expect to be able to provide uterine endometrial cancer patients with appropriate treatment that preserves their quality of life without compromising oncologic outcomes in the near future.
Funder
National Cancer Center Research and Development Fund
Publisher
Oxford University Press (OUP)
Subject
Cancer Research,Radiology, Nuclear Medicine and imaging,Oncology,General Medicine
Reference83 articles.
1. Cancer Statistics 2020:GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 cancers in 185 Countries;CA Cancer J Clin,2021
2. International patterns and trends in endometrial cancer incidence, 1978–2013;Lortet-Tieulent;J Natl Cancer Inst,2018
3. Japan Society of Gynecologic Oncology 2018 guidelines for treatment of uterine body neoplasms;Yamagami;J Gynecol Oncol,2020
4. Gynecologic cancer committee report in 2018;Yaegashi;Acta Obstet Gynaecol Jpn,2020