ABSTRACT
Endometrial cancer (EC) is the most common gynecologic malignancy in the United States (1,2). In the year 2001, approximately 36,000 new cases were diagnosed, and 6,500 women died as a result of the disease (3). Fortunately, most patients present with early stage disease and have an excellent prognosis. A combination of several large series reveals that 80% of patients are diagnosed in stages I and II (Table 1). For the medically operable candidate with early stage disease, surgery is the treatment of choice. While vaginal and laparoscopic routes have been used, the standard of therapy
still remains total abdominal hysterectomy, bilateral salpingo-oophorectomy, and surgical staging (4-7). Some authors have suggested that with surgical extirpation, a 90% survival rate is obtainable (8,9), though others have reported a 5-year survival rate closer to 75% for stage I disease (10). Despite the good overall survival for patients with early stage disease, local and distant recurrence continue to be problematic for select patients with high-risk disease. This chapter provides an overview of prognostic factors affecting outcome in patients with early stage EC and discusses rationales for surgical staging and different surgical approaches.
