Endometrial cancer

The incidence of endometrial cancer is increasing. The overall 5-year survival rate is high, reflecting early presentation in most cases, but outcomes for advanced disease remain poor. Surgery for low-risk disease may be undertaken by general gynaecologists, but all patients require specialist multidisciplinary input. The cornerstone of treatment remains surgery, and laparoscopic surgery is emerging as a means of reducing morbidity. Systematic lymphadenectomy in all cases is unjustified, and adjuvant radiotherapy is now given only to selected patients at high risk of recurrence. Chemotherapy is increasingly used in high-risk and advanced disease, although the optimum drug combination is unclear. Future developments are likely to include the emergence of molecularly targeted therapies as an addition to existing treatments and the possibility of fertility-sparing hormonal treatments in selected patients.