The Cochrane Column

Endometrial cancer is one of the most common gynecologic cancers in the West and 75% of affected women are postmenopausal. Most endometrial cancers are diagnosed with stage 1 disease. About 10% of women with stage 1 endometrial cancer treated with surgery alone are at risk for recurrence. This risk is significantly higher for some women with high-risk factors (the stage of the disease, depth of myometrial invasion, grade of the tumor, lymphovascular invasion and the patient’s age). The initial treatment for stage 1 disease is usually surgery including total abdominal hysterectomy and bilateral salpingooophorectomy. The chances of first relapse (usually in the upper vagina) can be reduced by adjuvant postoperative radiotherapy.