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
The main treatment for endometrial cancer is surgery to take out the uterus and cervix. This operation is called a hysterectomy. There are several types of hysterectomy:
- Simple or total abdominal hysterectomy—uterus is removed through a cut in the belly
- Vaginal hysterectomy—uterus is removed through vagina; may be choice for women who are too sick for other surgery
- Radical hysterectomy—uterus and tissue around it is removed; used if cancer has spread to cervix
Bilateral salpingo-oophorectomy is the removal of ovaries and fallopian tubes. It is often done with a hysterectomy for uterine cancer.
Other surgical procedures include:
Lymph Node Surgery
Lymph nodes are part of the immune system. The lymph node system is present all over the body. Cancer can travel from one site to other areas of the body through the lymph. Surgery may be done as part of testing to look for cancer spread or treatment to remove cancer. Types of lymph node surgery include:
Pelvic and para-aortic lymph node dissection —lymph nodes from the pelvis and the area next to the aorta are removed. The removed nodes are tested for endometrial cancer cells. This test helps to determine the stage of the cancer. It is often done at the same time as a hysterectomy.
Lymph node sampling —only a few of the lymph nodes in an area are removed.
Sentinel lymph node sampling —may be used in early-stage endometrial cancer if tests do not suggest spread of cancer. A dye is placed near the tumor. The first nodes to absorb the dye are called sentinel nodes. They are the ones most likely to be affected by spread of cancer. The sentinel nodes are removed and tested. If there is no cancer in sentinel nodes, no other nodes will be removed. This process may also be called sentinel mapping.
Pelvic washings (peritoneal lavage) —the surgeon “washes” the belly and pelvic spaces with salt water. The fluid is then collected and sent to the lab to look for cancer cells. The cancer stage and treatment may change if cancer cells are found.
Tumor Debulking —as much of the tumor as possible will be removed. Can help other treatments, like radiation or chemotherapy, work better. It might be helpful in treating some types of endometrial cancer.
Endometrial cancer. EBSCO DynaMed website. Available at:http://www.dynamed.com/topics/dmp~AN~T113952/Endometrial-cancer. Accessed December 13, 2019.
Endometrial cancer. Merck Manual Professional Version website. Available at: http://www.merckmanuals.com/professional/gynecology-and-obstetrics/gynecologic-tumors/endometrial-cancer. Accessed December 13, 2019.
Endometrial cancer. The American College of Obstetricians and Gynecologists website. Available at: https://www.acog.org/Patients/FAQs/Endometrial-Cancer. Accessed December 13, 2019.
Surgery for endometrial cancer. American Cancer Society website. Available at: https://www.cancer.org/cancer/endometrial-cancer/treating/surgery.html. Accessed December 13, 2019.
Treatment option overview. National Cancer Institute website. Available at: https://www.cancer.gov/types/uterine/patient/endometrial-treatment-pdq#section/_131. Accessed December 13, 2019.
Last reviewed January 2020 by EBSCO Medical Review Board Nicole S. Meregian, PA Last Updated: 11/4/2020