[Adjuvant treatment of early endometrial carcinomas]

ABSTRACT

Endometrial carcinoma is the most common gynaecological malignant disease in developed countries. About 80% of patients present with early stage disease can be diagnosed [limited uterine tumour stage I or II]. The surgery of first intention allows to individualize decisional prognosis factors of adjuvant therapy. Postoperative radiation therapy plays a major role in the management of stage I and II endometrial carcinoma, but the respective place of external beam radiotherapy and vaginal brachytherapy remains controversial. Several randomized studies have shown that adjuvant external beam radiotherapy reduces locoregional recurrences, but carries a risk of toxicity without overall survival benefits. This technique is restricted to patients with high risk endometrial cancer. For those with intermediate risk, exclusive vaginal brachytherapy ensure an excellent local control with less toxicity. The indication for adjuvant chemotherapy should be discussed in the group of patients with high risk endometrial cancer. But adjuvant hormone therapy is not recommended for early stage disease