|July 2009 · Vol. 21, No. 07
UPDATE: ENDOMETRIAL CANCER
Are lymphadenectomy and external-beam radiotherapy valuable in women who have an endometrial malignancy? Debate over the standard of care continues.
The outcome after lymphadenectomy tends to be better when surgery is performed by a trained gynecologic oncologist
The EN.5 and ASTEC trials found no benefit for external-beam radiotherapy in terms of overall, disease-specific, and recurrence-free survival, but a 2.9% decline in local recurrence
The small improvement in local control among women who received external-beam radiotherapy came at a cost: 3% of patients had acute severe or life-threatening toxicity from treatment
Dr. Mutch is Judith and Ira C. Gall Professor and Director of the Division of Gynecologic Oncology at Washington University in St. Louis.B. J.
Dr. Rimel is a Fellow in Gynecologic Oncology at Washington University in St. Louis.
Dr. Mutch reports that he has received grant or research support from Lilly and Genentech. He serves as a speaker for GSK, Lilly, and Merck. Dr. Rimel reports no financial relationships relevant to this article.
Endometrial cancer is a great concern in industrialized nations, where it is the most common gynecologic cancer—with incidence increasing every year. Survival is generally very good for women who have low-grade disease confined to the uterus. However, for patients who have high-grade disease, an aggressive histologic type, or other features that suggest a poor prognosis, the cure rate approaches 75%.1