More than 70% of women with stage II cancer of the endometrium are able to survive, free of disease, after treatment with surgery and post-surgical radiation therapy, researchers from Chicago recently reported.

Cancer of the endometrium is characterized by the presence of cancer cells in the lining of the uterus, or womb. Treatment options depend on many factors, including the type, grade, and stage (extent of disease at diagnosis) of disease. Stage II disease consists of cancer that involves both the uterus and the cervix (part of the body that connects the uterus to the vagina, or birth canal). A high percentage of women with stage II endometrial cancer are cured with surgery to remove the uterus (called total abdominal hysterectomy) as well as the ovaries and fallopian tubes (called bilateral salpingo-oophorectomy). These women may also receive radiation therapy after the surgery to help kill any remaining cancer cells and prevent a recurrence (return of cancer) later. To ensure that women with endometrial cancer are receiving the most effective treatment possible, it is important for researchers to evaluate and report on the outcomes of currently used treatment regimens, as well as to develop and study new strategies.

Researchers in Chicago recently evaluated the results of surgery, followed by radiation therapy, in 32 women with stage II endometrial cancer. The radiation therapy consisted of external-beam radiation therapy (high-energy rays projected from an external machine toward the body), brachytherapy (placement of radioactive implants into or near the cancer), or both. The results showed that 25% of the women had a recurrence of the cancer, outside the area of the pelvis. This type of recurrence was most common in women whose original cancer was located deep in the uterus or whose cancer cells looked high-grade, or “poorly differentiated” from normal cells, when viewed under a microscope. After 5 years, 72.4% of the women were alive and free of disease.

These findings show that a large percentage of women with stage II endometrial cancer are able to survive, free of disease, after treatment with surgery and post-surgical radiation therapy. However, further clinical studies are needed to investigate the effectiveness of additional therapies, such as hormone therapy or chemotherapy, in the 25% of women who are likely to suffer a recurrence. Persons who have stage II endometrial cancer may wish to talk with their doctor about the risks and benefits of participating in a clinical trial (research study) in which postoperative radiation therapy, combined with hormone therapy or chemotherapy, is being studied.

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(American Journal of Clinical Oncology, Vol 22, No 4, pp 338-343, 1999)