gynecology and obstetrics
Endometrial Cancer
Key Points
Endometrial cancer is one of the most common cancers among women. Prognosis is better with type I tumors, which are grade 1 or 2 endometrioid adenocarcinomas; they tend to beestrogen-responsive and diagnosed at a younger age. Recommend endometrial sampling for women with abnormal uterine bleeding, particularly those > 45 years; ultrasound assessment of endometrial thickness is an alternative for average-risk postmenopausal women. Stage endometrial cancer surgically via laparotomy, laparoscopy, or a robotic-assisted surgery. Treatment is usually total hysterectomy, bilateral salpingo-oophorectomy, and lymphadenectomy and sometimes radiation therapy and/or chemotherapy. Consider sentinel lymph node mapping for cancers that appear to be confined to the uterus. Consider fertility-sparing treatment for patients with grade 1 endometrioid adenocarcinoma or endometrial complex atypical hyperplasia. Consider genetic counseling and testing for patients < 50 years and those with a significant family history of endometrial, ovarian, and/or colorectal cancer (Lynch syndrome [hereditary nonpolyposis colorectal cancer]). 