Controversies in the management of endometrial cancer 2012

Endometrial cancer (EC) is the most frequent cancer of the female genital tract, especially in developed countries and the seventh most common cause of death from cancer in women in Western Europe. Major prognostic factors related to endometrial cancer are stage, grade, and depth of myometrial invasion and the presences of lymho-vascular space invasion. Standard treatment of EC consist of surgical and then adjuvant therapy on the basis of pathological prognostic factors. Standard surgical approach for stage I-II endomerial cancer is total hysterectomy and bilateral salpingo-oophorectomy with or without staging. Without question a comprehensive surgical staging procedure similar to that for ovarian carcinoma should be performed for non-endometrioid EC (uterine papiller serous carcinoma and clear cell adenocarcinoma) due to the aggressive clinical behavior. In contrast, there are some controversial issues in the surgical management-staging of EC and the role of ommentectomy and lymphadenectomy are the issues of current debate.