Postoperative therapy for uterine carcinoma. Overview of randomized trials

Abstract

Uterine carcinoma, the most common gynaecological cancer, consists of different clinicopathological subtypes. This malignancy is usually diagnosed in early stages, is associated with low potential of both local recurrence and distant metastases, and its outcome is generally good. Surgery continues to be the cornerstone of therapy for tumours limited to the uterus. The optimal postoperative therapy — indications and forms, is still not determined. Postoperative radiotherapy was a subject of a few randomised trials, which demonstrated increased local control but no impact on overall survival. Higher rate of distant than local relapses in uterine carcinoma suggests potential role of systemic therapy in this malignancy. The benefit of postoperative endocrine or chemotherapy has not been confirmed in the randomised study. However, the most recently published, pooled results of two trials suggested prolongation of progression-free survival with the use of postoperative chemotherapy in addition to adjuvant radiotherapy in high-risk patients.