Book contents
- 50 Big Debates in Gynecologic Oncology
- 50 Big Debates in Gynecologic Oncology
- Copyright page
- Contents
- Contributors
- Section I Perioperative Management
- Section II Screening, Prevention, and Early Diagnosis
- Section III Ovarian Cancer
- Section IV Endometrial Cancer
- Debate 28A Fertility-sparing Surgery in Early-stage Endometrial Cancer is Safe and Does not Compromise Oncological Outcome
- Debate 28B Fertility-sparing Treatment for Early-stage Endometrial Cancer is Safe and Does Not Compromise Oncological Outcome
- Debate 29A Sentinel Lymph Node Mapping Should be the Standard for Staging Patients with High-grade Endometrial Cancers
- Debate 29B Sentinel Lymph Node Mapping Should be the Standard for Staging Patients with High-grade Endometrial Cancers
- Debate 30A Molecular Profiling Should be Done to Guide the Management of Endometrial Cancer?
- Debate 30B Molecular Profiling Should be Done to Guide the Management of Endometrial Cancer?
- Debate 31A What is the Best Adjuvant Therapy for Management of Stage III Endometrial Cancer?
- Debate 31B What is the Best Adjuvant Therapy for Management of Stage III Endometrial Cancer?
- Debate 32A How Should Stage IA Serous Papillary Endometrial Cancer Confined to a Polyp or the Endometrial Lining be Managed?
- Debate 32B How Should Stage IA Serous Papillary Endometrial Cancer Confined to a Polyp or the Endometrial Lining be Managed?
- Debate 33A What is the Optimal Sequence of Therapy for Patients with Stage IIIC Endometrial Carcinoma Treated with Multimodal Therapy?
- Debate 33B What is the Optimal Sequence of Therapy for Patients with Stage IIIC Endometrial Carcinoma Treated with Multimodal Therapy?
- Debate 34A Should an Attempt at Debulking Grossly Metastatic Endometrial Cancer be Undertaken?
- Debate 34B Should an Attempt at Debulking Grossly Metastatic Endometrial Cancer be Undertaken?
- Debate 35A Should Secondary Cytoreduction be Performed for Recurrent Endometrial Cancer?
- Debate 35B Should Secondary Cytoreduction be Performed for Recurrent Endometrial Cancer?
- Debate 36A Is Hormonal Therapy the Best Therapy for Chemo-resistant Endometrial Cancer?
- Debate 36B Is Hormonal Therapy the Best Therapy for Chemo-resistant Endometrial Cancer?
- Debate 37A Is there a Role for Using Immunotherapy in Endometrial Cancer?
- Debate 37B Is there a Role for Using Immunotherapy in Endometrial Cancer?
- Debate 38A What is the Best Chemotherapy Regimen for Uterine Carcinosarcoma?
- Debate 38B What is the Best Chemotherapy Regimen for Uterine Carcinosarcoma?
- Debate 39A What is the Best Management for Premenopausal Women with Early-stage Uterine Leiomyosarcoma Status Post Hysterectomy for Presumed Uterine Leiomyomas?
- Debate 39B What is the Best Management for Premenopausal Women with Early-stage Uterine Leiomyosarcoma Status Post Hysterectomy for Presumed Uterine Leiomyomas?
- Debate 40A Should Primary Debulking Surgery be Performed for Metastatic Leiomyosarcoma?
- Debate 40B Should Primary Debulking Surgery be Performed for Metastatic Leiomyosarcoma?
- Debate 41A Should Secondary Cytoreductive Surgery be Offered to all Patients that are Surgical Candidates with Optimally Resectable Recurrent Uterine Leiomyosarcoma?
- Debate 41B Should Secondary Cytoreductive Surgery be Offered to all Patients that are Surgical Candidates with Optimally Resectable Recurrent Uterine Leiomyosarcoma?
- Section V Cervical Cancer
- Section VI Vaginal and Vulvar Cancer
- Index
- References
Debate 29A - Sentinel Lymph Node Mapping Should be the Standard for Staging Patients with High-grade Endometrial Cancers
Yes
from Section IV - Endometrial Cancer
Published online by Cambridge University Press: 20 July 2023
Book contents
- 50 Big Debates in Gynecologic Oncology
- 50 Big Debates in Gynecologic Oncology
- Copyright page
- Contents
- Contributors
- Section I Perioperative Management
- Section II Screening, Prevention, and Early Diagnosis
- Section III Ovarian Cancer
- Section IV Endometrial Cancer
- Debate 28A Fertility-sparing Surgery in Early-stage Endometrial Cancer is Safe and Does not Compromise Oncological Outcome
- Debate 28B Fertility-sparing Treatment for Early-stage Endometrial Cancer is Safe and Does Not Compromise Oncological Outcome
- Debate 29A Sentinel Lymph Node Mapping Should be the Standard for Staging Patients with High-grade Endometrial Cancers
- Debate 29B Sentinel Lymph Node Mapping Should be the Standard for Staging Patients with High-grade Endometrial Cancers
- Debate 30A Molecular Profiling Should be Done to Guide the Management of Endometrial Cancer?
- Debate 30B Molecular Profiling Should be Done to Guide the Management of Endometrial Cancer?
- Debate 31A What is the Best Adjuvant Therapy for Management of Stage III Endometrial Cancer?
- Debate 31B What is the Best Adjuvant Therapy for Management of Stage III Endometrial Cancer?
- Debate 32A How Should Stage IA Serous Papillary Endometrial Cancer Confined to a Polyp or the Endometrial Lining be Managed?
- Debate 32B How Should Stage IA Serous Papillary Endometrial Cancer Confined to a Polyp or the Endometrial Lining be Managed?
- Debate 33A What is the Optimal Sequence of Therapy for Patients with Stage IIIC Endometrial Carcinoma Treated with Multimodal Therapy?
- Debate 33B What is the Optimal Sequence of Therapy for Patients with Stage IIIC Endometrial Carcinoma Treated with Multimodal Therapy?
- Debate 34A Should an Attempt at Debulking Grossly Metastatic Endometrial Cancer be Undertaken?
- Debate 34B Should an Attempt at Debulking Grossly Metastatic Endometrial Cancer be Undertaken?
- Debate 35A Should Secondary Cytoreduction be Performed for Recurrent Endometrial Cancer?
- Debate 35B Should Secondary Cytoreduction be Performed for Recurrent Endometrial Cancer?
- Debate 36A Is Hormonal Therapy the Best Therapy for Chemo-resistant Endometrial Cancer?
- Debate 36B Is Hormonal Therapy the Best Therapy for Chemo-resistant Endometrial Cancer?
- Debate 37A Is there a Role for Using Immunotherapy in Endometrial Cancer?
- Debate 37B Is there a Role for Using Immunotherapy in Endometrial Cancer?
- Debate 38A What is the Best Chemotherapy Regimen for Uterine Carcinosarcoma?
- Debate 38B What is the Best Chemotherapy Regimen for Uterine Carcinosarcoma?
- Debate 39A What is the Best Management for Premenopausal Women with Early-stage Uterine Leiomyosarcoma Status Post Hysterectomy for Presumed Uterine Leiomyomas?
- Debate 39B What is the Best Management for Premenopausal Women with Early-stage Uterine Leiomyosarcoma Status Post Hysterectomy for Presumed Uterine Leiomyomas?
- Debate 40A Should Primary Debulking Surgery be Performed for Metastatic Leiomyosarcoma?
- Debate 40B Should Primary Debulking Surgery be Performed for Metastatic Leiomyosarcoma?
- Debate 41A Should Secondary Cytoreductive Surgery be Offered to all Patients that are Surgical Candidates with Optimally Resectable Recurrent Uterine Leiomyosarcoma?
- Debate 41B Should Secondary Cytoreductive Surgery be Offered to all Patients that are Surgical Candidates with Optimally Resectable Recurrent Uterine Leiomyosarcoma?
- Section V Cervical Cancer
- Section VI Vaginal and Vulvar Cancer
- Index
- References
Summary
The recommended treatment of endometrial cancer is total hysterectomy, bilateral salpingo-oophorectomy, and lymph node assessment. Fertility-sparing options are supported only by retrospective data. Complete durable responses to continuous progestins for fertility-sparing are only 50%, with recurrence rates of 35%. Moreover, there is recent evidence that fertility-sparing treatment negatively affects progression-free survival. These substantial risks must be weighed against the modest live birth rates of approximately 28% with 81% of live births requiring the assistance of reproductive technology. Ovarian preservation after hysterectomy is another option, however the risk of synchronous ovarian cancer may be higher in young women, and the opportunity to diagnose familial cancer syndromes may be missed. Further prospective and long-term studies must be performed to assess oncologic outcomes associated with fertility-sparing treatment in early-stage endometrial cancer before this option can be deemed safe.
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- Information
- 50 Big Debates in Gynecologic Oncology , pp. 171 - 173Publisher: Cambridge University PressPrint publication year: 2023
References
Holloway, RW, et al. Sentinel lymph node mapping and staging in endometrial cancer: a society of gynecologic oncology literature review with consensus recommendations, Gynecol Oncol 2017;146:405–415. https://doi.org/10.1016/j.ygyno.2017.05.027CrossRefGoogle ScholarPubMed
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