Adjuvant Chemotherapy for Endometrial Cancer

The prognosis of early-stage endometrial cancer is favorable, even when treated using surgery alone, whereas recurrent cases or advanced cases (stage III or IV) with progression beyond the uterus have a poor prognosis1), and therapy for such cancers is still in the exploratory stages. Stage I and II cases are sometimes treated with adjuvant therapy to prevent recurrence after surgical therapy; however, the treatment options for these cases remain controversial. The boundaries encompassing intermediate risk cases may be approached in several ways, and it would be difficult to say that any consensus has been reached, although examples often include stage IIB (FIGO stage 1988) and higher, stage IC endometrioid adenocarcinoma, all grade 3 (poorly-differentiated) endometrioid adenocarcinoma, non-endometrioid adenocarcinoma, and marked lymphovascular space invasion2,3). Radiation therapy and chemotherapy are the two primary modalities of postoperative adjuvant therapy for patients with these types of endometrial cancer characterized by a poor prognosis or a risk of recurrence. In this chapter, we first refer briefly to adjuvant radiotherapy.