Adjuvant treatment for stage IIIC endometrial cancer: Options and controversies

Endometrial cancer is the most common gynecologic malignancy. Locally advanced and high risk endometrial cancer encompasses a heterogeneous group of patients and optimal treatment for various sub-groups of these patients remains controversial. Stage IIIC is the most common sub-stage of patients with locally advanced endometrial carcinoma. This article reviews retrospective and prospective data of various adjuvant treatment approaches involving chemotherapy, radiation therapy, or combined modality therapy, including the recently proposed “sandwich” regimens that have yielded encouraging results. Areas of controversy are also discussed to assist clinicians in identifying the most effective adjuvant treatment regimens for patients with locally advanced disease. On-going randomized trials are briefly discussed.

Research highlights
► Retrospective and prospective studies have proposed and supported a variety of adjuvant treatment strategies for stage IIIC endometrial carcinoma.
► Level 1 evidence exists both for and against a benefit of adjuvant systemic chemotherapy for these patients.
► Retrospective and prospective data has been gathered using a treatment strategy of combined chemotherapy and radiation therapy, and this appears to be a promising approach.