Treatment of stage I and stage II endometrial cancer
Low-risk endometrial cancer (grade 1 or grade 2)
Treatment of low-risk stage I endometrial cancer and stage II endometrial cancer may include the following:
- Surgery (total hysterectomy and bilateral salpingo-oophorectomy). Lymph nodes in the pelvis and abdomen may also be removed and viewed under a microscope to check for cancer cells.
- Surgery (total hysterectomy and bilateral salpingo-oophorectomy, with or without removal of lymph nodes in the pelvis and abdomen) followed by internal radiation therapy. In certain cases, external radiation therapy to the pelvis may be used in place of internal radiation therapy.
- Radiation therapy alone for patients who cannot have surgery.
- A clinical trial of a new chemotherapy regimen.
- If cancer has spread to the cervix, a radical hysterectomy with bilateral salpingo-oophorectomy may be done.
High-risk endometrial cancer (grade 3)
Treatment of high-risk stage I endometrial cancer and stage II endometrial cancer may include the following:
- Surgery (radical hysterectomy and bilateral salpingo-oophorectomy). Lymph nodes in the pelvis and abdomen may also be removed and viewed under a microscope to check for cancer cells.
- Surgery (radical hysterectomy and bilateral salpingo-oophorectomy) followed by chemotherapy and sometimes radiation therapy.
Treatment of stage III, stage IV, and recurrent endometrial cancer
Treatment of stage III endometrial cancer, stage IV endometrial cancer, and recurrent endometrial cancer may include the following:
- Surgery (radical hysterectomy and removal of lymph nodes in the pelvis so they can be viewed under a microscope to check for cancer cells) followed by adjuvant chemotherapy and/or radiation therapy.
- Chemotherapy and internal and external radiation therapy for patients who cannot have surgery.
- Hormone therapy for patients who cannot have surgery or radiation therapy.
- Targeted therapy with mTOR inhibitors (everolimus or ridaforolimus) or a monoclonal antibody (bevacizumab).
- A clinical trial of a new treatment regimen that may include combination chemotherapy, targeted therapy, such as an mTOR inhibitor (everolimus) or signal transduction inhibitor (metformin), and/or hormone therapy, for patients with advanced or recurrent endometrial cancer.