Management of Endometrial Cancer at Mayo Clinic: Intensive Surgical Staging and Disease-based Postoperative Treatment

Abstract

Chapter 1 is a general introduction, while chapter 8 is the final discussion and conclusions.

The remaining chapters (from 2 to 7) are composed by a brief introduction, followed by the published article(s) that form(s) the structure of the chapter. Management of Endometrial Cancer at Mayo Clinic: Intensive Surgical Staging and Disease-based Postoperative Treatment Endometrial cancer is the most common malignancy of the female genital tract, and it is the fourth most frequently diagnosed cancer in women. Of major concern is the realization that while the incidence of endometrial carcinoma has remained stable over the past 2 decades, the number of deaths annually from this disease has more than doubled. Presumably the cause of these sobering statistics are multifactorial, but it obligates us to reassess more objectively and critically the screening, diagnostic, staging, and treatment processes that guide the overall management of this neoplasm. In the present manuscript we performed a review of selected publications from Mayo Clinic on endometrial cancer that appeared in the literature during the last decade. We gave a contribution to a better definition of the role of lymphadenectomy and surgical staging in endometrial cancer. Moreover, we defined a different approach to postoperative management. In fact, as opposed to modality-based therapy (i.e. using radiotherapy in patients considered at high risk for recurrence), we introduced the concept of disease-based postoperative treatment, targeting the predicted site of recurrent disease. We defined guidelines for the management of endometrial cancer, in the attempt of improving the treatment approach to endometrial cancer and the outcome of patients.