USMLE Step 2 CK Lecture Notes 2019: Obstetrics/Gynecology (Kaplan Test Prep)

Table II-4-4. Management    of  Endometrial Carcinoma

TAH-BSO:    Basic   Treatment   for All Stages

Stage I

TAH

BSO

Lymph   node    dissection

—

Stage II Radiation

Stage III Radiation, chemotherapy

Stage IV

Surgical therapy.   The mainstay    of  treatment   of  endometrial carcinoma   is  a

total   abdominal   hysterectomy    (TAH)   and bilateral   salpingo-oophorectomy

(BSO),  pelvic  and para-aortic lymphadenectomy,    and peritoneal  washings.

Radiation therapy.  An  evaluation  of  the postoperative   pathology   report  will

classify    patients    into    poor    or  good    prognosis.  Patients    with    poor    prognosis

should  be  considered  for radiation   therapy.    Poor    prognostic  factors include

metastasis  to  lymph   nodes,  >50%    myometrial  invasion,   positive    surgical

margins,    or  poorly  differentiated  histology.

Chemotherapy.   Medical treatment   is  used    for metastatic  disease and involves

progestins  and cytotoxic   agents.