Surgical staging in endometrial cancer

Endometrial cancer is the most prevalent cancer of the female genital tract. No randomised study exists to prove that pelvic and para-aortic lymphadenectomy increases survival, either by dissecting micrometastases or by altering the adjuvant treatment in all early stage (stage I grade 1 and 2) endometrial cancer patients. For lymph node metastases, adverse histology, deep myometrial invasion and cervical involvement are independent prognostic factors. We discuss the indication for full surgical staging in early endometrial cancer. In case a lymphadenectomy is indicated, this should always include a full pelvic and para-aortic lymphadenectomy. Lymphadenectomy does not replace adjuvant radiotherapy.