Patients with diffuse stage 1a endometrial cancer should be treated aggressively. Treatment includes surgery, radiation therapy, chemotherapy or progestin therapy.
1. Surgical treatment: stage 1a refers to the tumor is confined to the uterine body and infiltrates less than one-half of the myometrium. Secondary extensive total uterine, double adnexa, pelvic and para-abdominal aortic lymph node dissection is performed. Preservation of ovaries can be considered for young patients without risk factors.
2. Radiation therapy: there are two kinds of irradiation: brachytherapy and extracorporeal irradiation. It is divided into simple radiotherapy and combined radiotherapy. Simple radiotherapy is suitable for patients with contraindications to surgery or inoperable patients. Stage 1a patients should be treated with simple intracavitary brachytherapy. Combined radiotherapy can reduce the local recurrence of tumor and improve the survival of tumor.
3. Chemotherapy: cisplatin and paclitaxel are commonly used, which can be combined with progesterone.
4. Progesterone therapy: commonly used methylhydroxyprogesterone acetate, medroxyprogesterone and so on.
After checking out endometrial cancer, patients should actively cooperate with doctor’s treatment, and the above drugs should be used according to doctor’s prescription.