Endometrial cancer (EC) poses a significant health issue among women, and its incidence has been rising for a couple of decades. Surgery remains its principal treatment method and may have a curative, staging, or palliative aim. The type and extent of surgery depends on many factors, and the risks and benefits should be carefully weighed. While simple hysterectomy might be sufficient in early stage EC, modified-radical hysterectomy is sometimes indicated. In advanced disease, the evidence suggests that, similarly to ovarian cancer, optimal cytoreduction improves survival rate. The role of lymphadenectomy in EC patients has long been a controversial issue. The rationale for systematic lymphadenectomy and the procedure of the sentinel lymph node biopsy are thoroughly discussed. Finally, the impact of the molecular classification and new International Federation of Gynecology and Obstetrics (FIGO) staging system on EC treatment is outlined. Due to the increasing knowledge on the pathology and molecular features of EC, as well as the new advances in the adjuvant therapies, the surgical management of EC has become more complex. In the modern approach, it is essential to adjust the extent of the surgery to a specific patient, ensuring an optimal, made-to-measure personalized surgery. This narrative review focuses on the intricacies of surgical management of EC and aims at summarizing the available literature on the subject, providing an up-to-date clinical guide.
子宫内膜癌是女性健康的重要威胁，其发病率在过去数十年间持续上升。手术仍是该疾病的主要治疗手段，可达到根治、分期或姑息治疗的目的。手术方式与范围取决于多种因素，需审慎权衡风险与获益。早期子宫内膜癌可能仅需单纯子宫切除术，而改良根治性子宫切除术有时亦属必要。对于晚期患者，现有证据表明与卵巢癌相似，实现满意肿瘤细胞减灭术可提高生存率。淋巴结清扫术在子宫内膜癌治疗中的价值长期存在争议，本文系统探讨了系统性淋巴结清扫的理论依据及前哨淋巴结活检的操作流程。同时，文中概述了分子分型与国际妇产科联盟新版分期系统对治疗策略的影响。随着对子宫内膜癌病理机制和分子特征认知的深化，以及辅助治疗手段的进步，其手术治疗体系日趋复杂。现代诊疗理念强调根据患者个体特征精准制定手术方案，实现量体裁衣式的个性化治疗。本综述聚焦子宫内膜癌手术治疗的复杂性，旨在系统梳理该领域现有文献，为临床实践提供前沿指导。
Range of Resection in Endometrial Cancer—Clinical Issues of Made-to-Measure Surgery
肿瘤(癌症)患者之家