Stage IB endometrial cancer treatment

Written by Xu Xiao Ming
Obstetrics and Gynecology
Updated on September 15, 2024
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Endometrial carcinoma Stage IB refers to tumors localized to the body of the uterus, where tumor infiltration is less than half of the myometrium. Surgical treatment is feasible for this stage and involves a slightly extensive total hysterectomy coupled with bilateral adnexectomy. During the surgery, a frozen section pathology test should be conducted. If the pathology report from the frozen section indicates special types of endometrial-like cancer, including papillary serous adenocarcinoma, clear cell carcinoma, squamous cell carcinoma, carcinosarcoma, and undifferentiated carcinoma, additional procedures are required. Moreover, if enlarged para-aortic or common iliac lymph nodes are palpated during the surgery, lymphadenectomy of the pelvic and para-aortic lymph nodes should be performed.

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Written by Zhang Xiu Rong
Obstetrics and Gynecology
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Is a thick endometrium the same as cancer?

Endometrial thickening is not necessarily cancerous. Causes of endometrial thickening generally include irregular hyperplasia or endometrial polyps, both of which can lead to thickening of the endometrium, but this is not necessarily indicative of cancer. Whether it is endometrial cancer is usually determined if patients with endometrial thickening do not show clear improvement after treatment with medication. Typically, a curettage procedure is performed to collect tissue for pathological examination. If the pathology report indicates endometrial cancer or precancerous lesions, then it will be reported. Therefore, endometrial thickening is not necessarily indicative of endometrial cancer, and it can occur with conditions like endometrial polyps or irregular endometrial hyperplasia. Treatment at this stage should be based on the pathological results. Thus, while endometrial thickening should be taken seriously, it is not necessarily cancerous.

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Written by Liu Jian Wei
Obstetrics and Gynecology
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How is endometrial cancer diagnosed?

In the clinical setting, when endometrial cancer is suspected, further pathological examination is required. Generally, endometrial tissue can be obtained through fractional curettage or hysteroscopic endometrial biopsy. The acquired endometrium is then subject to a pathological examination, observing the morphology of the endometrial cells under a microscope. If cancer cells are detected, a diagnosis of endometrial cancer can be made. Therefore, the confirmation of endometrial cancer in clinical practice must be based on pathological examination.

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Written by Li Shun Hua
Obstetrics and Gynecology
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Is endometrial hyperplasia the same as cancer?

Endometrial hyperplasia is not cancer; it is caused by a prolonged absence of ovulation, which means there is no secretion of progesterone. This prevents the proliferative phase endometrium from transforming into the secretory phase, leading to hyperplasia. If the hyperplasia persists over an extended period, it may lead to precancerous changes in the endometrium, and in severe cases, it can cause endometrial cancer. Therefore, it is essential to treat endometrial hyperplasia with progesterone, which can transform the endometrium and allow it to shed completely, altering its condition and restoring it to normal. As long as there is ovulation, there is the production of progesterone, so promoting ovulation is crucial.

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Written by Liu Jian Wei
Obstetrics and Gynecology
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How to perform surgery for endometrial cancer

Surgical treatment for endometrial cancer needs to be determined based on the specific stage and type of the cancer, as well as the size of the lesions. If the lesions are small and the cancer is in an early stage, a complete hysterectomy including the removal of both fallopian tubes and ovaries can be performed. Intraoperative pathology assessment of the endometrium is also necessary to determine the specific pathological type. If it is a special type of endometrial cancer, it is also necessary to clear the pelvic lymph nodes. If the endometrial cancer is at a later stage and the lesions are larger, then in addition to the removal of the uterus and both fallopian tubes and ovaries, it is also necessary to clear the lymph nodes around the abdominal aorta in the pelvis.

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Written by Xu Xiao Ming
Obstetrics and Gynecology
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Endometrial cancer requires chemotherapy.

If endometrial cancer has high-risk factors, chemotherapy is needed after surgery if these high-risk factors are found in the pathological staging. If it's early-stage endometrial cancer without these high-risk factors, chemotherapy might not be necessary after surgery because chemotherapy also serves to prevent recurrence and metastasis. Therefore, it is advised that patients with high-risk factors in endometrial cancer undergo chemotherapy. Although chemotherapy may have significant side effects, it can improve the survival time and quality of life for cancer patients. The decision to proceed with chemotherapy should be based on the postoperative pathological staging, biopsy results, and the presence or absence of factors like lymph node metastasis.