Diagnosis
1. Fr D&C
+ cervical biopsy
2.
Hysteroscope directed biopsy
Risk
factor
1.
Obesity
2.
Nulliparity
3. Late
menopause
Stage Ia G123 Tumor limited to endometrium
Ib G123 Invasion of less than half of the
myometrium
Ic G123 Invasion of more than half of the
myometrium
IIa G123 Endocervical glandular involvement only
IIb G123 Cervical stromal invasion
IIIa G123 Tumor invades serosa 、 adnexae
、 positive cytology
IIIb G123 Vaginal metastases
IIIc G123 Metastases to pelvic and/or
paraaortic lymph nodes
IVa G123 Tumor invasion of bladder and/or
bowel mucosa
IVb Distant metastases 、 inguinal lymph
node
Histopatholgoy: Degree of differentiation
Cases of
carcinoma of the corpus should be grouped according to the degree of
differentiation of the adenocarcinoma as follows:
G1 = 5%
or less of a nonsquamous or nonmorular solid growth pattern
G2 = 6%
to 50% of a nonsquamous or nonmorular solid growth pattern
G3 = more
than 50% of a nonsquamous or nonmorular solid growth pattern
Pre-operative survey
1.
Sonography
2.
Abdomino-pelvic CT
3. MRI (optional)
4. IVP
5. LGI
Primary
treatment
1.
Comprehensive surgery
washing
cytology + ATH (or Extended ATH) + BSO + Bilateral pelvic lymph node
dissection + paraaortic LN sampling analysis (when Gr3 or deep
myometrial involvement)
2.
specimen sent for hormone receptor and flow cytometricDNA ploidy
Risk
factor (indicators for post-operative therapy)
1.
Histologic differentiation
2. Stage
of disease
3.
Myometrial invasion
4.
Peritoneal cytology
5. Lymph
node metastasis
6.
Adnexal metastasis
7.
Hormonal receptor
8. DNA
ploidy
Adjuvant
therapy
1.
Radiotherapy:
a. whole
pelvis with/or without vaginal brachytherapy
b. whole
pelvis + entended PA field
2.
Chemotherapy:
a.
splatin, adriamycin, epirubicin, paciltaxel
3.
Hormone therapy:
a.
megestrol acetate: 160 mg/d-320 mg/d
b.
tamoxifen: 20-60 mg/d
c. GnRHa:
Lupron depot 3.75 mg SC/month
