Amant Frederic, Moerman Philippe, Neven Patrick, Timmerman Dirk, Van Limbergen Erik, Vergote Ignace
Leuven Cancer Institute (LKI), UZ Gasthuisberg, Katholieke Universiteit, Leuven, Belgium.
Curr Opin Oncol. 2007 Sep;19(5):479-85. doi: 10.1097/CCO.0b013e32827853c0.
Endometrial cancer is the most common malignancy of the female genital tract. This review highlights new insights and these will change current practice.
Surgery is the cornerstone of the treatment of endometrial cancer but the metastatic pattern is different for types 1 and 2. The surgical staging procedure therefore depends on subtype. Type 2 endometrial cancers often metastasize to the lymph nodes and peritoneal cavity and patients should undergo a staging procedure similar to that performed for ovarian cancer. Laparoscopic staging and treatment for endometrial cancer appears to be safe and effective. Adequate staging also serves to appropriately tailor adjuvant treatment modalities that benefit high-risk patients only. Recent data suggest adequate staging to improve the overall survival. In addition, following complete surgical staging, recent studies emphasize the benefit for adjuvant chemotherapy in early stage serous endometrial cancer. Adjuvant chemotherapy appears to be more effective than radiotherapy for type 1 cancers. In the primarily advanced or recurrent setting, hormonal treatment may be beneficial. Doxorubicin-cisplatin is still the standard chemotherapy regime used in many centres; paclitaxel-containing regimes also appear to show promise.
Recent data shed new light on the current concepts of tumour spread, surgical staging and adjuvant treatment modalities for endometrial cancer.
子宫内膜癌是女性生殖道最常见的恶性肿瘤。本综述重点介绍了新见解，这些见解将改变当前的治疗实践。
手术是子宫内膜癌治疗的基石，但1型和2型的转移模式不同。因此，手术分期程序取决于亚型。2型子宫内膜癌常转移至淋巴结和腹腔，患者应接受类似于卵巢癌的分期程序。腹腔镜分期及治疗子宫内膜癌似乎是安全有效的。充分的分期也有助于合理调整辅助治疗方式，仅使高危患者受益。近期数据表明充分分期可提高总体生存率。此外，在完成手术分期后，近期研究强调了早期浆液性子宫内膜癌辅助化疗的益处。对于1型癌症，辅助化疗似乎比放疗更有效。在主要为晚期或复发的情况下，激素治疗可能有益。多柔比星-顺铂仍是许多中心使用的标准化疗方案；含紫杉醇的方案似乎也显示出前景。
近期数据为子宫内膜癌肿瘤扩散、手术分期及辅助治疗方式的当前概念提供了新的线索。
