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Surgical Procedures for Uterine (Endometrial) Cancer

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Surgery is the main treatment for uterine cancer in all stages. The goal of surgery is to remove as much cancer as possible. Surgery offers the best chance for a cure if uterine cancer is found in early stages. The type of surgery depends on the stage of the cancer. Radiation or chemotherapy may be done after surgery to kill any remaining cancer cells.

Surgery for Early Stage and Advanced Uterine Cancer

There different options for surgery. The choice will depend on how aggressive the cancer is and how far it has spread. Some options will spare the ovaries. This will prevent early menopause and preserve fertility. Options include:

  • Total hysterectomy—remove uterus, cervix
  • Total hysterectomy bilateral salpingo-oophorectomy—also removes ovaries and fallopian tubes
  • Radical hysterectomy—remove uterus, cervix, and part of the vagina. Ovaries, fallopian tubes, and nearby lymph nodes

There are a number of ways these surgeries may be done:

  • Open —an cut is made in the belly. The surgeon will be able to see the uterus and surrounding tissue.
  • Vaginal —Tools and a scope are passed through the vagina. Incisions in the belly will not be needed. Tissue can be removed through the vagina.
  • Laparoscopic —Small cuts are made in the belly. Tools and a scope can be passed through the cuts. Tissue can also be removed through the small cuts. Recovery time for this surgery is often faster than with open surgery.
  • Robotic assisted —this is similar to laparoscopic surgery. However, robotic arms are are used to do the work. This allows for greater range of movement than a doctor's hand.

Other surgical procedures include:

  • Sentinel node biopsy —A sentinel node is the first lymph node that a tumor drains into. If the node is cancer free, it is unlikely that the cancer has spread. If cancer is present, more lymph nodes may be removed to see how far the cancer has traveled.
  • Pelvic and para-aortic lymph node dissection —Lymph nodes in the pelvis and around the aorta will be removed and examined under a microscope. The aorta is the largest artery in the body.
  • Omentectomy —The omentum is a large apron-like tissue that covers the inside of the belly. It may need to be removed.
  • Debulking —tumors that have grown in the pelvis or belly cavity may be removed. It may be done with other surgeries or as a separate surgery.
REFERENCES:

Endometrial cancer. EBSCO DynaMed Plus website. Available at:http://www.dynamed.com/topics/dmp~AN~T113952/Endometrial-cancer. Updated May 24, 2017. Accessed December 13, 2017.

Endometrial cancer. Merck Manual Professional Version website. Available at: http://www.merckmanuals.com/professional/gynecology-and-obstetrics/gynecologic-tumors/endometrial-cancer. Updated March 2017. Accessed December 13, 2017.

Endometrial cancer. The American College of Obstetricians and Gynecologists website. Available at: https://www.acog.org/Patients/FAQs/Endometrial-Cancer. Updated June 2016. Accessed December 13, 2017.

Surgery for endometrial cancer. American Cancer Society website. Available at: https://www.cancer.org/cancer/endometrial-cancer/treating/surgery.html. Updated November 20, 2017. Accessed December 13, 2017.

Treatment option overview. National Cancer Institute website. Available at: https://www.cancer.gov/types/uterine/patient/endometrial-treatment-pdq#section/_131. Updated October 13, 2017. Accessed December 13, 2017.

Last reviewed December 2017 by EBSCO Medical Review Board Mohei Abouzied, MD, FACP  Last Updated: 12/13/2017