How to perform surgery for endometrial cancer

Written by Liu Jian Wei
Obstetrics and Gynecology
Updated on September 09, 2024
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Surgical treatment for endometrial cancer needs to be determined based on the specific stage and type of the cancer, as well as the size of the lesions. If the lesions are small and the cancer is in an early stage, a complete hysterectomy including the removal of both fallopian tubes and ovaries can be performed. Intraoperative pathology assessment of the endometrium is also necessary to determine the specific pathological type. If it is a special type of endometrial cancer, it is also necessary to clear the pelvic lymph nodes. If the endometrial cancer is at a later stage and the lesions are larger, then in addition to the removal of the uterus and both fallopian tubes and ovaries, it is also necessary to clear the lymph nodes around the abdominal aorta in the pelvis.

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Written by Xu Xiao Ming
Obstetrics and Gynecology
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Does endometrial cancer require chemotherapy?

Whether chemotherapy is needed for endometrial cancer depends on its clinical stage. If it is advanced endometrial cancer, such as stage IV, chemotherapy is necessary for these patients. Recurrent endometrial cancer also requires chemotherapy. In the case of early-stage endometrial cancer, surgery can be used. The purpose of the surgery is to stage the pathology of the cancer to determine the extent of endometrial cancer infiltration. After the surgery, it will be assessed whether chemotherapy is needed. Therefore, whether chemotherapy is needed for endometrial cancer depends on the surgical staging. Some endometrial cancers may require not only chemotherapy but also radiotherapy treatment.

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Written by Zhang Lu
Obstetrics
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How is endometrial cancer staged?

Endometrial cancer is a common gynecological malignancy in women. Based on surgical and pathological results, endometrial cancer can be divided into four stages. Stage I is the mildest form of endometrial cancer, where the cancer is confined only within the endometrium and does not extend beyond the uterine serosa. Generally, stage 1a is when the cancer is less than half the width of the muscle, while stage 1b is when the cancer infiltrates more than half the width of the muscle. Stage II means the cancer has locally spread but only involves the cervix, without causing cervical stromal infiltration. Stage III involves local spread to the serosa and lymph nodes. Stage IV involves distant metastasis, such as to the liver and bones.

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Written by Xu Xiao Ming
Obstetrics and Gynecology
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Endometrial cancer requires chemotherapy.

If endometrial cancer has high-risk factors, chemotherapy is needed after surgery if these high-risk factors are found in the pathological staging. If it's early-stage endometrial cancer without these high-risk factors, chemotherapy might not be necessary after surgery because chemotherapy also serves to prevent recurrence and metastasis. Therefore, it is advised that patients with high-risk factors in endometrial cancer undergo chemotherapy. Although chemotherapy may have significant side effects, it can improve the survival time and quality of life for cancer patients. The decision to proceed with chemotherapy should be based on the postoperative pathological staging, biopsy results, and the presence or absence of factors like lymph node metastasis.

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Written by Shen Li Wen
Obstetrics and Gynecology
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Early symptoms of endometrial cancer

When endometrial cancer occurs in women, it first manifests as abnormal proliferation of the endometrium, increased endometrial surface area, and increased secretions, which can increase the pressure inside the uterine cavity, leading to lower abdominal pain in women. Most women can tolerate this pain, but it tends to worsen during vigorous activities or sexual intercourse. Vaginal discharge may become watery and increase. Additionally, some women may experience increased menstrual flow or irregular vaginal bleeding. Over time, this can lead to blood loss anemia in women, manifesting as dizziness, fatigue, and changes in appetite.

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Written by Li Lin
Obstetrics and Gynecology
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Stage IA endometrial cancer

Endometrial cancer is a group of epithelial malignant tumors that occur in the endometrium. Clinically, the surgical pathology staging revised by the World Health Organization in 2000 is mainly used, based on the severity of the lesion after surgery. Endometrial cancer can be divided into four stages, where, depending on the size and severity of the lesion, it can further be classified into sub-stages a, b, and c. Stage IA refers to cancer limited to the endometrium and is the earliest stage of endometrial cancer. Stage IA endometrial cancer can be completely cured with surgical treatment.