| Endometrial
carcinoma most commonly presents in FIGO Stage 1. This means that
the disease is confined to the body of the uterus and there is no
evidence of metastasis. If there is presence of distant metastasis
it is then FIGO Stage 4. Five year survival in FIGO Stage 4 is
less than 10%. The standard
treatment for endometrial carcinoma is total abdominal
hysterectomy and bilateral salphingo-oophorectomy, para-aortic
node sampling, intra-operative uterine assessment to determine the
depth of endometrial invasion and immediate pelvic lymphadenectomy
where there is deep myometrial penetration by tumour or the
initial tumour is poorly differentiated. Post-operative radiation
therapy to vagina and pelvis is given in selected high risk cases.
Endometrial cancers are normally detected
early at stage 1, hence there are very few cases with stage 4.
As such gynaecologists do not have much experience with stage 4
patients.
According to FIGO classification, in stage
4 endometrial cancer the tumour has extended outside the true
pelvis or has obviously involved the mucosa of the bladder or
rectum. The sites of extrapelvic tumour extension are commonly
lungs, lymph nodes (inguinal, supraclavicular, axillar), bones and
bladder.
Once the disease has spread outside the
pelvis, it is difficult to treat it successfully by surgery and/or
radiotherapy. The only systemic therapy available is to use
progestagens.
If you have questions related to this article you may e-mail me
at doctor@soontongkiong.com quoting the contents of the article.
About the author
DR SOON is a medical practitioner. He holds four degrees. MBBS
(University of Malaya), MBA (University of East Asia), LLB (Hons)
(University of Wolverhampton), Master of Medicine (Edith Cowan
University).
:
Dr SOON is the owner of AskMyVisitor.com and MyScriptDoctor.com
where you can find the most up-to-date advice and information
on
many medical, health and lifestyle topics.
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