About the book
Endometrial cancer (EC) is the second most common malignancy of the female reproductive system. The disease usually affects postmenopausal women and the most common presenting symptom is abnormal uterine bleeding. It is widely acceptable that, systematic surgical staging represents the primary EC treatment. Pelvic and para-aortic lymphadenectomy remains an essential part of systematic surgical staging and provides meaningful data regarding the necessity of postoperative adjuvant treatment. However, pelvic and para-aortic lymphadenectomy are associated with significant morbidity. In this light, sentinel lymph node mapping and dissection becomes very popular and epitomizes an equilibrium between systematic lymphadenectomy and no lymphadenectomy in well selected EC patients of low and intermediate risk. Moreover, the dissected sentinel lymph nodes should be evaluated with the ultrastaging approach.
It is interesting to note that, almost 4% of EC patients are below 40 years of age and their management represents a great challenge. Nevertheless, the non-surgical fertility sparing approach could be offered only in well-defined subgroups of young EC patients with early stage disease, strong desire for fertility preservation and detailed counselling.
The clinical role of molecular targeted therapies as an adjuvant treatment in EC patients, remains under investigation. However, there are some promising results regarding their beneficial role in well-defined subgroups of EC patients with specific molecular profile. In conclusion, the early diagnosis as well as the appropriate therapeutic management of EC patients have a direct effect on their quality of life and overall survival. Moreover, the extent of surgical staging as well as the type of postoperative adjuvant treatment should be thoroughly individualized based on EC type, disease stage, fertility issues and patient’s general performance status. The main aim of this book project, is to present most recent advances in diagnosis and treatment of EC.