Recent Trend of the Postoperative Adjuvant Therapy in Endometrial Cancer.

Kim, Byoung Gie

Review

Korean Journal of Obstetrics & Gynecology 2005;48(11):2510-2526.
Published online November 1, 2005.

Recent Trend of the Postoperative Adjuvant Therapy in Endometrial Cancer.

Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicne, Seoul, Korea. bgkim@smc.samsung.co.kr

Abstract

Endometrial cancer is a third common female malignancy in Korea, affecting approximately 714 women per year. Despite the publication of several prospective randomized trials, there continues to be controversy regarding the use of adjuvant therapy in endometrial cancer management. It is clear that most women with earlystage, low-risk disease will do well without adjuvant therapy. Intermediate-risk patients are at risk for local regional relapse, and radiotherapy has been shown to effectively reduce this risk without significantly impacting overall survival. The absence of a clear impact on survival has resulted in a lack of consensus regarding the use of radiotherapy in intermediate-risk patients. At the same time, the patterns of failure in intermediate-risk patients have resulted in differing recommendations regarding appropriate radiotherapy targets. High-risk patients are at risk for both local and distant failure, and chemotherapy has been shown to improve outcome in these patients. High-risk patients are also at risk for local failure, and targeted radiotherapy may be appropriate. In this article, we discuss the controversies surrounding the use of adjuvant radiotherapy in endometrial cancer using an evidence-based approach and along the National Comprehensive Cancer Network 2005 practice guideline.

Key Words: Endometrial cancer, Adjuvant therapy, Radiation therapy, Chemotherapy, Prognosis