Commentary (Moller): Surgical Staging in Endometrial Cancer

Endometrial cancer is the most common gynecologic malignancy affecting women in the United States. In 1988, the International Federation of Gynecology and Obstetrics shifted from a clinical staging protocol to one based on surgical factors, making surgical staging the accepted treatment approach to endometrial cancers, with excellent survival compared to other gynecologic malignancies. The manuscript by Kirby et al brings to light the controversies surrounding the surgical evaluation of endometrial cancers. Although surgical staging has been shown to have both prognostic and therapeutic benefit, major problems in the United States continue to result in suboptimal treatment of patients with endometrial cancer. These problems include the lack of an accepted surgical protocol (in terms of adequacy of lymph node sampling) and incomplete surgical staging secondary to patient factors or the lack of referral to specialty-trained gynecologic oncologists.