The best treatment for uterine cancer

Uterine cancer is one of the most common cancers in middle-aged and elderly women. Especially with the development of China's aging society, the incidence of uterine cancer has increased year by year. The best treatment for uterine cancer has also caused widespread discussion. Treatments for uterine cancer include surgery, radiotherapy, progesterone therapy, anti-estrogen preparations, chemotherapy, etc. Which one is the best treatment for uterine cancer? Let's discuss it today.

Surgery is the preferred treatment method. The purpose of surgery is to perform surgery and pathological staging to determine the scope of the lesion and important factors related to prognosis; second, to remove the cancerous uterus and other possible metastatic lesions. During the operation, a comprehensive exploration is first performed, and samples of suspected lesions are taken for frozen section examination; and ascites or pelvic and abdominal lavage fluid is retained for cytological examination.

The uterine specimen removed by dissection should be examined to determine whether there is myometrial invasion. The specimen removed by surgery should be routinely examined by pathology, and the cancerous tissue should also be tested for estrogen and progesterone receptors as a basis for the selection of adjuvant therapy after surgery. Stage I patients should undergo extrafascial total hysterectomy and bilateral adnexectomy.

Pelvic and para-aortic lymph node resection or sampling should be performed in patients with any of the following conditions: special pathological types such as papillary serous adenocarcinoma, clear cell carcinoma, squamous cell carcinoma, undifferentiated carcinoma, etc.; endometrioid adenocarcinoma G3; depth of myometrial invasion; cancer lesions involving more than 50% of the uterine cavity or involvement of the isthmus.

In view of the high malignancy of endometrial papillary serous carcinoma and its early lymph node metastasis and pelvic and abdominal metastasis, the scope of surgery for clinical stage I should be the same as that for ovarian cancer. In addition to staging exploration, removal of the uterus and bilateral adnexa and clearance of retroperitoneal lymph nodes, the greater omentum and appendix should also be removed. In stage II, total hysterectomy or extensive hysterectomy and bilateral adnexectomy should be performed, and pelvic and para-aortic lymph node resection should be performed at the same time. The scope of surgery for advanced patients in stages III and IV is also the same as that for ovarian cancer, and tumor cell reduction surgery should be performed.