Can endometrial cancer be cured?

  Endometrial cancer is an epithelial malignant tumor occurring in the endometrium, with adenocarcinoma being the most common, and is one of the three major malignant tumors of the female reproductive tract (cervical cancer, endometrial cancer and ovarian cancer). In the very early stage or early stage of the disease (before in situ cancer or metastasis), active surgical treatment is possible to cure the disease.  Since endometrial cancer mostly manifests as irregular vaginal bleeding or post-menopausal bleeding in early stage, many patients will actively seek medical consultation, early detection and early treatment, therefore, the cure rate of endometrial cancer is much higher than that of cervical cancer and ovarian cancer. About 80% of patients can be detected early and the cure rate is about 70-80%. However, if endometrial cancer is not diagnosed in time and infiltrates beyond the plasma layer of uterus and reaches beyond the uterus, the cure rate is very poor because of its low sensitivity to radiotherapy and chemotherapy.  Surgery is the preferred treatment option for endometrial cancer, especially for early-stage patients, and adjuvant treatment is chosen after surgery according to high-risk factors. The purpose of surgery is, firstly, to perform surgical-pathological staging (nowadays, the revised surgical pathology of the International Federation of Obstetrics and Gynecology in 2009 is divided into stages I, II and III) to determine the extent of lesions and factors related to prognosis, and secondly, to remove the diseased uterus and other possible metastatic lesions. Currently, laparoscopic techniques are mostly used, such as laparoscopic total extrafascial hysterectomy and bilateral adnexal resection in stage I patients, plus laparoscopic pelvic lymph node dissection and sampling of para-aortic lymph nodes if necessary. Next, radiotherapy, chemotherapy and progesterone therapy can be used.  After endometrial cancer treatment, about 75-95% of recurrences occur within 2-3 years after surgery. Factors affecting prognosis include: malignancy degree of tumor and lesion scope, such as surgical pathological stage, histological type, tumor grading, depth of myometrial infiltration, lymphatic metastasis and extra-uterine metastasis; patient’s systemic condition; choice of treatment plan.