Radiotherapy in the management of nodal and peritoneal metastases

Abstract

Endometrial carcinoma clinically confined to the uterus is all too infrequently cured, despite virtually complete control of pelvic tumor by contemporary surgical and radiotherapeutic techniques. Although selected series have achieved somewhat better results, five-year survival rates worldwide are 75% for Stage I and 58% for Stage II endometrial carcinomas and have not substantially improved over the past few decades, despite high rates of operability and widespread utilization of pelvic adjuvant radiation therapy [1]. Occult peritoneal and lymph node metastases are responsible for a major fraction of recurrences. Although earlier studies had hinted at an appreciable rate of nodal and peritoneal spread in early endometrial carcinoma, its importance was not fully proven until the data of the Gynecologic Oncology Group became available [2, 3]. Simultaneously, information was generated concerning the efficacy of radiation for treatment of such metastases [4, 5]. Perhaps the next decade will witness an improvement in cure, as appropriate surgical staging and extended field radiation therapy techniques gain greater acceptance.