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Management of endometrial carcinoma with cervical involvement. An unsettled issue
1Department of Obstetrics and Gynecology, Gynecologic Oncology Unit, Edith Woljson Medical Center, Holon, Sackler Faculty of Medicine, Tel-Aviv, University, Tel-Aviv, Israel
*Corresponding Author(s): J. Menczer E-mail:
The purpose of the present report is to review the various management options of endometrial carcinoma with cervical involvement. A Medline literature search for publications dealing with endometrial carcinoma (EC) with cervical involvement and treatment was made. Although many publications deal with EC with cervical involvement there is a lack of prospective controlled trials. Only one prospective randomized phase III trial has been published. The inaccuracies of clinical staging, the scarcity of reports with surgically staged patients, the multiple types of cervical involvement and prognostic indicators and the remarkable variations in treatment render it difficult to compare outcome results between publications. The small number of patients in many of these studies and their retrospective uncontrolled nature add to this difficulty. There are conflicting reports with regard to factors affecting outcome, also complicating the management issue of endometrial carcinoma with cervical involvement and comparison of treatment results. The optimal management of EC with cervical involvement remains to be established.
Endometrial carcinoma; Cervical involvement; Treatment
J. Menczer. Management of endometrial carcinoma with cervical involvement. An unsettled issue. European Journal of Gynaecological Oncology. 2005. 26(3);245-255.
[1] Creasman W., Odicino F., Maisonneuve P., Beller U., Benedet J.L., Heintz A.P. et al.: "Carcinoma of the corpus uteri". In: "Annual Report on the Results of Treatment in Gynecological Cancer". J. Epidemiol. Biostat., 2001, 6, 45.
[2] Leminen A., Forss M., Lehtovirta P.: "Endometrial adenocarcinoma with clinical evidence of cervical involvement: accuracy of diagnostic procedures, clinical course, and prognostic factors". Acta Obstet. Gynecol. Scand., 1995, 74, 61.
[3] Watanabe M., Aoki Y., Kase H., Fujita K., Tanaka K.: "Low risk endometrial cancer: A study of pelvic lymph node metastasis". int. J. Gynecol. Cancer, 2003, 13, 38.
[4] Heyman J., Reuterwall 0., Brenner S.: "Radiumhemmet experience with radiotherapy in cancer of the corpus of the uterus: classification, method and results". Acta Radiol., 1941, 22, 11.
[5] Kottmeier H.L.: "The classification and clinical staging of carcinoma of the uterus and vagina". J. int. Fed. Gynecol. Obstet., 1963, 1, 83.
[6] Ahmad K., Kim Y.H., Deppe G., Malone J., Herskovic A., Ratanatharathorn V. et al.: "Radiation therapy in Stage II carcinoma of the endometrium". Cancer, 1989, 63, 854.
[7] Boothby R.A., Carlson J.A., Neiman W., Rubin M.M., Morgan M.A., Schultz D. et al.: "Treatment of Stage II endometrial carcinoma". Gynecol. Oneal., 1989, 33, 204.
[8] Jereczek-Fossa B.A.: "Postoperative irradiation in endometrial cancer: still a matter of controversy". Cancer Treat. Rev., 2001, 27, 19.
[9] Surwit E.A., Fowler W.C. Jr., Rogoff E.E., Jelovsek F., Parker R.T., Creasman W.T.: "Stage II carcinoma of the endometrium". Int. J. Radiat. Oncol. Biol. Phys., 1979, 5, 323.
[10) Kadar N.R., Kohorn E.l., LiVolsi V.A., Kapp D.S.: "Histologic variants of cervical involvement by endometrial carcinoma".Obstet. Gynecol., 1982, 59, 85.
[11] Berman M.L., Afridi M.A., Kanbour A.I., Ball H.G.: "Risk factors and prognosis in Stage II endometrial cancer". Gynecol. Oncol., 1982, 14, 49.
[12] Cowles T.A., Magrina J.F., Masterson BJ., Capen C.V.: "Comparison of clinical and surgical-staging in patients with endometrial carcinoma". Obstet. Gynecol., 1985, 66, 413.
[13] Frauenhoffer E.E., Zaino R.J., Wolff T.V., Whitney C.E.: "Value of endocervical curettage in the staging of endometrial carcinoma". Int. J. Gynecol. Pathol., 1987, 6, 195.
[14] Wolfson A.H., Sightler S.E., Markoe A.M., Schwade J.G., Averette H.E., Ganjei P. et al.: "The prognostic significance of surgical staging for carcinoma of the endometrium". Gynecol. Oncol., 1992, 45, 142.
[15] Mannel R.S., Berman M.L., Walker J.L., Manetta A., DiSaia P.J.: "Management of endometrial cancer with suspected cervical involvement" Obstet. Gynecol., 1990, 75, 1016.
[16] Yura Y., Tauchi K., Koshiyama M.: "Parametrial involvement in endometrial carcinomas: its incidence and correlation with other histological parameters". Gynecol. Oncol., 1996, 63, 114.
[17] Sato R., Jobo T., Kuramoto H.: "Parametrial spread as a prognostic factor in endometrial carcinoma". Eur. J. Gynecol. Oncol., 2003, 24, 241.
[18] Feuer G.A., Calanog A.: "Endometrial carcinoma: treatment of positive paraaortic nodes". Gynecol. Oncol., 1987, 27, 104.
[19] Larson D.M., Johnson K.: "Pelvic and para-aortic lymphadenectomy for surgical staging of high risk endometrioid adenocarcinoma of the endometrium". Gynecol. Oncol., 1993, 79, 998.
[20] Tang X., Tanemura K., Ye W., Ohmi K., Tsunematsu R., Yamada T. et al.: "Clinicopathological factors predicting retroperitoneal lymph node metastasis and survival in endometrial cancer". Jpn. J. Clin. Oncol., 1998, 28, 673.
[21] Hirahatake K., Hareyama H., Sakuragi N., Nishiya M., Makinoda S., Fujimoto S.: "A clinical and pathologic study on para-aortic lymph node metastasis in endometrial carcinoma". J. Surg. Oncol., 1997, 65, 82.
[22] Ayhan A., Tuncer R., Tuncer Z.S., Yuce K., Kucukali T.: "Correlation between clinical and histopathologic risk factors and lymph node metastases in early endometrial cancer (a multivariate analysis of 183 cases)". Int. J. Gynecol. Cancer, 1994, 4, 306.
[23] Mariani A., Webb M.J., Keeney G.L., Podratz K.C.: "Routes of lymphatic spread: a study of 112 consecutive patients with endometrial cancer" Gynecol. Oncol., 2001, 81, 100.
[24] Boente M.P., Yordan E.L. Jr., McIntosh D.G., Grendys E.C. Jr., Orandi Y.A., Davies S. et al.: "Prognostic factors and long term survival in endometrial adenocarcinoma with cervical involvement". Gynecol. Oncol., 1993, 51, 316.
[25] Larson D.M., Copeland L.J., Gallager H.S., Kong J.P., Wharton J.T., Stringer C.A.: "Stage II endometrial carcinoma. Results and comphcations of a combined radiotherapeutic-surgical approach". Cancer, 1988, 61, 1528.
[26] Irwin W.P., Rice L.W.: "Advances in the management of endometrial adenocarcinoma". J. Reprod. Med., 2002, 47, 173.
[27] Larson D.M., Copeland L.J., Gallager H.S., Gershenson D.M., Freedman R.S., Wharton J.T. et al.: "Nature of cervical involvement in endometrial carcinoma". Cancer, 1987, 59, 959.
[28] Lanciano R.M., Curran W.J. Jr., Greven K.M., Fanning J., Stafford P., Randall M.E. et al.: "Influence of grade, histologic subtype, and timing of radiotherapy on outcome among patients with Stage II carcinoma of the endometrium". Gynecol. Oncol., 1990, 39, 368.
[29] Jobsen J.J., Schutter E.M., Meerwaldt J.H., Van Der Palen J., Van Der Sijde R., Ten Cate L.N.: "Treatment results in women with clinical stage I and pathologic Stage II endometrial carcinoma". Int. J. Gynecol. Cancer, 2001, 11, 49.
[30] Greven K.M., Corn B.W., Case D., Purser P., Lanciano R.M.: "Which prognostic factors influence the outcome of patients with surgically staged endometrial cancer treated with adjuvant radiation?". Int. J. Radial. Oncol. Biol. Phys., 1997, 1, 39, 413.
[31] Eltabbakh G.H., Moore A.D.: "Survival of women with surgical Stage II endometrial cancer". Gynecol. Oncol., 1999, 74, 80.
[32] Mariani A., Webb M.J., Keeney G.L., Calori G., Podratz K.C.: "Role of wide/radical hysterectomy and pelvic lymph node dissection in endometrial cancer with cervical involvement". Gynecol. Oneal., 2001, 83, 72.
[33] International Federation of Gynecology and Obstetrics: "Annual report on the results of treatment in gynecologic cancer". Int. J. Gynecol Obstet., 1989, 28, 189.
[34] Boronow R.C.: "Carcinoma of the corpus: treatment at M.D. Anderson Hospital". In: Cancer of the Uterus and Ovary. Chicago: Year Book Medical Publishers, 1969, 35.
[35] Trimble E.L., Jones H.W. 3nd: "Management of Stage II endometrial adenocarcinoma". Ohstet. Gynecol., 1988, 71 (3 Pt 1), 323.
[36] Podczaski E.S., Kaminski P., Manetta A., Louk D., Andrews C., Larson J. et al.: "Stage II endometrial carcinoma treated with external-beam radiotherapy, intracavitary application of cesium, and surgery". Gynecol. Oneal., 1989, 35, 251.
[37] Higgins R.V., van Nagell J.R. Jr., Horn E.J., Roberts S.L., Donaldson E.S., Gallion H.H. et al.: "Preoperative radiation therapy followed by extrafascial hysterectomy in patients with Stage II endometrial carcinoma". Cancer, 1991, 68, 1261.
[38] Reisinger S.A., Staros E.B., Feld R., Mohiuddin M., Lewis G.C.: "Preoperative radiation therapy in clinical Stage II endometrial carcinoma" Gynecol. Oncol., 1992, 45, 174.
[39] Zablow A., Adams M., Gregori C., Breen J.L., Sanfilippo L.J.: "Stage II adenocarcinoma of the endometrium treated by two standard regimens of combined preoperative irradiation and surgery". Int. J. Gynecol. Cancer, 1994, 4, 265.
[40] Maingon P., Arnould L., Magnin V., Collin F., Belichard C., Fraisse J. et al.: "Preoperative radiotherapy and surgery for endometrial carcmoma prognostic significance of the sterilization of the specimen". Int. J. Radial. Oneal. Biol. Phys., 1998, 41, 551.
[41] Maingon P., Horiot J.C., Fraisse J., Salas S., Collin F., Bone-Lepinoy M.C. et al.: "Preoperative radiotherapy in stage I/II endometrial adenocarcinoma". Radiother. Oncol., 1996, 39, 201.
[42] Andersen E.S.: "Stage II endometrial carcinoma: prognostic factors and the results of treatment". Gynecol. Oncol., 1990, 38, 220.
[43] Feltmate C.M., Duska L.R., Chang Y., Flynn C.E., Nikrui N., Kiggundu E. et al.: "Predictors of recurrence in surgical Stage II endometrial adenocarcinoma". Gynecol. Oncol., 1999, 73, 407.
[44] Weiss E., Hirnle P., Arnold-Bofinger H., Hess C.F., Bamberg M.:'Therapeutic outcome and relation of acute and late side effects in the adjuvant radiotherapy of endometrial carcinoma Stage I and II". Radiother. Oncol., 1999, 53, 37.
[45] Sartori E., Gadducci A., Landoni F., Lissoni A., Maggino T., Zola P. et al.: "Clinical behavior of 203 Stage II endometrial cancer cases: the impact of primary surgical approach and of adjuvant radiation therapy". Int. J. Gynecol. Cancer, 2001, 11, 430.
[46] Cornelison T.L., Trimble E.L., Kosary C.L.: "SEER data, corpus uteri cancer: treatment trends versus survival for FIGO Stage II, 1988-1994" Gynecol. Oncol., 1999, 74, 350.
[47] Fanning J.: "Long-term survival of intermediate risk endometrial cancer (Stage 1G3, IC, II) treated with full lymphadenectomy and brachytherapy without teletherapy". Gynecol. Oncol., 2001, 82, 371.
[48] Fanning J., Navati P.J., Hilgers R.D.: "Surgical staging and high dose rate brachytherapy for endometrial cancer: limiting external radiotherapy to node positive tumors". Obstet. Gynecol., 1996, 87, 1041.
[49] Horowitz N.S., Peters W.A. 3'', Smith M.R., Drescher C.W., Atwood M., Mate T.P.: "Adjuvant high dose rate vaginal brachytherapy as treatment of Stage I and II endometrial carcinoma". Ohstet. Gynecol., 2002, 99, 235.
[50] Ng T.Y., Nicklin J.L., Perrin L.C., Cheuk R., Crandon A.J.: "Postoperative vaginal vault brachytherapy for node-negative Stage II (occult) endometrial carcinoma". Gynecol. Oneal., 2001, 81, 193.
[51] Keys H.M., Roberts J.A., Brunetto V.L., Zaino R.J., Spirtos N.M., Bloss J.D. et al.: "A phase III trial of surgery with or without adjunctive external pelvic radiation therapy in intermediate risk endometrial adenocarcinoma: a Gynecologic Oncology Group study". Gynecol. Oneal., 2004, 92, 744.
[52] Lanciano R.M., Corn B.W., Schultz D.J., Kramer C.A., Rosenblum N., Hogan W.M.: "The justification for a surgical staging system in endometrial carcinoma". Radiother. Oncol., 1993, 28, 189.
[53] Grigsby P.W., Perez C.A., Camel H.M., Kao M.S., Galakatos A.E.: "Stage II carcinoma of the endometrium: results of therapy and prognostic factors". Int. J. Radial. Oneal. Biol. Phys., 1985, 11, 1915.
[54] Onsrud M., Aalders J., Abeler V., Taylor P.: "Endometrial carcinoma with cervical involvement (Stage II): prognostic factors and value of combined radiological surgical treatment". Gynecol. Oncol., 1982, 13, 76.
[55] Calais G., Vitu L., Descamps P., Body G., Reynaud-Bougnoux A., Lansac J. et al.: "Preoperative or postoperative brachytherapy for patients with endometrial carcinoma Stage I and II". Int. J. Radiat. Oncol. Biol. Phys., 1990, 19, 523.
[56] Rose P.G., Baker S., Kern M., Fitzgerald T.J., Tak W.K., Reale F.R. et al.: "Primary radiation therapy for endometrial carcmoma: a case controlled study". Int. J. Radiat. Oneal. Biol. Phys., 1993, 27, 585.
[57] Varia M., Rosenman J., Halle J., Walton L., Currie J., Fowler W.: "Primary radiation therapy for medically inoperable patients with endometrial carcinoma-Stages I-II". Int. J. Radiat. Oneal. Biol. Phys., 1987, 13, 11.
[58] Taghian A., Pernot M., Hoffstetter S., Luporsi E., Bey P.: "Radiation therapy alone for medically inoperable patients with adenocarcinoma of the endometrium". Int. J. Radiat. Oneal. Biol. Phys., 1988, 15, 1135.
[59] Morrow C.P., Bundy B.N., Homesley H.D., Creasman W.T., Hornback N.B., Kurman R. et al.: "Doxorubicin as an adjuvant following surgery and radiation therapy in patients with high-risk endometrial carcinoma, Stage I and occult Stage II: a Gynecologic Oncology Group Study" Gynecol. Oncol., 1990, 36, 166.
[60] von Minckwitz G., Loibl S., Brunnert K., Kreienberg R., Melchert F., Mosch R. et al.: "Adjuvant endocrine treatment with medroxyprogesterone acetate or tamoxifen in Stage I and II endometrial cancer. A multicentre, open, controlled, prospectively randomized trial". Eur. J. Cancer, 2002, 38, 2265.
[61] Boente M.P., Orandi Y.A., Yordan E.L., Miller A., Graham J.E., Kirshner C. et al.: "Recurrence patterns and complications in endometrial adenocarcinoma with cervical involvement". Ann. Surg. Oncol., 1995, 2, 138.
[62] Morrow C.P., Bundy B.N., Kurman R.J., Creasman W.T., Heller P., Homesley H.D. et al.: "Relationship between surgical pathological risk factors and outcome in clinical Stage I and II carcinoma of the endometrium: a Gynecologic Oncology Group study". Gynecol. Oncol., 1991, 40, 55.
[63] Wallin T.E., Malkasian G.D. Jr., Gaffey T.A., O'Brien P.C., Fountain K.S.: "Stage II cancer of the endometrium: a pathologic and clinical study". Gynecol. Oneal., 1984, 18, 1.
[64] Larson D.M., Copeland L.J., Gallager H.S., Wharton J.T., Gershenson D.M., Rutledge F.N.: "The significance of residual tumor after preoperative pelvic irradiation for Stage II endometrial carcinoma". Obstet. Gynecol., 1987, 70, 916.
[65] Homesley H.D., Boronow R.C., Lewis J.L. Jr.: "Stage II endometrial adenocarcinoma. Memorial Hospital for Cancer, 1949-1965". Obstet. Gynecol., 1977, 49, 604.
[66] Kinsella T.J., Bloomer W.D., Lavin P.T., Knapp R.C.: "Stage II endometrial carcinoma: IO-year follow-up of combined radiation and surgical treatment". Gynecol. Oneal., 1980, 10, 290.
[67] Kadar N., Malfetano J.H., Homesley H.D.: "Determinants of survival of surgically staged patients with endometrial carcinoma histologically confined to the uterus: implications for therapy". Obstet. Gynecol., 1992, 80, 655.
[68] Reisinger S.A., Staros E.B., Mohiuddin M.: "Survival and failure analysis in Stage II endometrial cancer using the revised 1988 FIGO staging system". Int. J. Radiat. Oneal. Biol. Phys., 1991, 21, 1027.
[69] Zaino R.J., Kurrnan R.J., Diana K.L., Morrow C.P.: "The utility of the revised International Federation of Gynecology and Obstetrics histologic grading of endometrial adenocarcinoma using a defined nuclear grading system. A Gynecologic Oncology Group study". Cancer, 1991, 75, 81.
[70] Maggino T., Romagnolo C., Zola P., Sartori E., Landoni F., Gadducci A.: "An analysis of approaches to the treatment of endometrial cancer in western Europe: a CTF study". Eur. J. Cancer, 1995, 31A, 1993.
[71] Kinkel K., Kaji Y., Yu K.K., Segal M.R., Lu Y., Powell C.B. et al. Radiologic staging in patients with endometrial cancer: A meta-analysis". Radiology, 1999, 212, 711.
[72] Belhocine T., De Barsy C., Hustinx R., Willems-Foidart J.: "Usefulness of (18)F FDG PET in the post-therapy surveillance of endometrial carcinoma". Eur. J. Nucl. Med. Mol. Imaging, 2002, 29, 1132.
[73] Boronow R.C.: "Surgical staging of endometrial cancer: evolution, evaluation, and responsible challenge-a personal perspective". Gynecol. Oneal., 1997, 66, 179.
[74] Thomas L., Bremond A., Fondrinier E., Fondrinier E., Fervers B., Achard J.L. et al.: "Standards, options, and recommendations for radiotherapy of patients with endometrial cancer. FNCLCC (National Federation of Cancer Campain Centers) and CRLCC (Regional Cancer Campain Centers)". Cancer Radiother., 2001, 5, 163.
[75] Orr J.W. Jr., Roland P.Y., Leichter D., Orr P.F.: "Endometrial cancer: is surgical staging necessary?". Curr. Opin. Oneal., 2001, 13, 408.
[76] Rutledge F.: "The role of radical hysterectomy in adenocarcinoma of the endornetriurn". Gynecol. Oneal., 1974, 2, 331.
[77] Mariani A., Webb M.J., Galli L., Podratz K.C.: "Potential therapeutic role of para aortic lyrnphadenectomy in node-positive endornetrial cancer". Gynecol. Oneal., 2000, 76, 348.
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