Endometrial cancer. Issue 10333 (9th April 2022)

• Record Type: Journal Article
• Authors: Crosbie, Emma J; Kitson, Sarah J; McAlpine, Jessica N; Mukhopadhyay, Asima; Powell, Melanie E; Singh, Naveena
• Is Part Of: Lancet. Volume 399:Issue 10333(2022)
• Page Start: 1412
• Page End: 1428
• Publication Date: 2022-04-09
• Subjects: Medicine -- Periodicals; Medicine -- Periodicals; Medicine; Medicine; Electronic journals; Periodicals; 610.5
• DOI: 10.1016/S0140-6736(22)00323-3
• Languages: English
• ISSNs: 0140-6736

Abstract

Summary: Endometrial cancer is the most common gynaecological cancer in high income countries and its incidence is rising globally. Although an ageing population and fewer benign hysterectomies have contributed to this trend, the growing prevalence of obesity is the major underlying cause. Obesity poses challenges for diagnosis and treatment and more research is needed to offer primary prevention to high-risk women and to optimise endometrial cancer survivorship. Early presentation with postmenopausal bleeding ensures most endometrial cancers are cured by hysterectomy but those with advanced disease have a poor prognosis. Minimally invasive surgical staging and sentinel-lymph-node biopsy provides a low morbidity alternative to historical surgical management without compromising oncological outcomes. Adjuvant radiotherapy reduces loco-regional recurrence in intermediate-risk and high-risk cases. Advances in our understanding of the molecular biology of endometrial cancer have paved the way for targeted chemotherapeutic strategies, and clinical trials will establish their benefit in adjuvant, advanced, and recurrent disease settings in the coming years.