The evolution of a treatment program for adenocarcinoma of the endometrium.

Previous studies at the University of Minnesota suggest that overall survival rates after treatment for adenocarcinoma of the endometrium are related to increased surgical applicability, that vaginal recurrence is frequently related to cervical involvement, and that virtually all women can safely undergo abdominal hysterectomy and radical irradiation therapy. In this program a simple abdominal hysterectomy was applied to as many women with this disease as possible. High-risk patients also received preoprative or postoperative irradiation. This program increased the survival rate for all stages from 58% to 69.7%. The survival rate among women with Stage I high-risk disease treated with supplementary irradiation was significantly lower when compared to that among women with low-risk disease who were treated by surgery alone. No vaginal recurrences were observed in either group and 98.4% were operated upon. The survival rate of women with Stage II disease treated with irradiation and surgery improved significantly. The rate of vaginal recurrence was 2.2%.