[Our experience in the surgical treatment of advanced endometrial cancers].

AIM

Our aim was to summarise our experience in the surgical treatment of advanced endometrial cancers for 20 years period.

MATERIAL AND METHODS

The patients were treated surgically by extrafascial hysterectomy, radical hysterectomy with pelvic and paraaortal lymph node dissection, by pelvic exenteration and by cytoreductive surgery (350 patients). The radical hysterectomy was applied in patients with stage II endometrial cancer.

RESULTS

When cytoreductive surgery was used, we observed difference in the five years survival rate when the residual tumour was < or = 2 cm and > 2 cm in diameter. Better survival rate was observed in the first group with < or = 2 cms in diameter. The five years survival rate in patients treated with radical hysterectomy versus patients treated by extrafascial hysterectomy was 89% vs.68%. In patients with pelvic and paraaortal lymph node dissection the survival was 69%, while in patients only with pelvic dissection was 38%. According to our results the aggressive cytoreductive surgery betters the survival in endometrial cancer stage III-IV.

CONCLUSIONS

The improvement in the adjuvant therapy may give an additional light in the treatment of advanced endometrial cancers. The radical hysterectomy with pelvic and paraaortal lymph node dissection improves significantly the overall survival rate of these patients. The optimal cytoreduction also leads to improvement of the survival in patients with advanced endometrial cancers.