In this paper, an overview of the literature on the management of recurrent endometrial cancer is presented, focusing on patients with histopathologic endometrioid type of tumors. The different treatment modalities are described, and a management recommendation scheme is presented. Indications for surgical treatment depend on resectability, site and size of the tumor, and performance status of the patient. Indications for radiotherapy depend on the site of the recurrence and also on the initial therapy received. When considering systemic treatment for patients with recurrent endometrial cancer, it is important to take into account the general health status and condition of the patient as well as which prior therapy the patient has received. The treatments of choice for patients with hormone-sensitive tumors (positive receptor levels, low-grade tumors, and long disease-free interval) are progestagens as first-line treatment and tamoxifen as second-line treatment. Patients with high-grade tumors, negative hormone receptor levels, and short treatment-free interval are best treated with chemotherapy. Paclitaxel, doxorubicin, and cisplatin are the most active combination therapy for these patients but with significant toxicity. In phase II studies, the combination therapy with paclitaxel and carboplatin seems to be as effective but less toxic and can be administered in outpatient clinic. The literature on the management of patients with recurrent endometrial cancer is discussed in detail. The different sites of recurrent disease (ie, local, regional, and/or distant) are evaluated separately; management recommendations are proposed, and alternative approaches are given.

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Keywords Endometrial cancer, Management, Recurrent, advanced cancer, anastrozole, cancer combination chemotherapy, cancer patient, cancer radiotherapy, cancer recurrence, cancer surgery, cancer survival, carboplatin, cisplatin, clinical trial, disease free survival, disease severity, doxorubicin, endometrioid carcinoma, endometrium cancer, endometrium carcinoma, functional status, gestagen, goserelin, histopathology, hormonal therapy, hormone, human, hydroxyprogesterone caproate, letrozole, leuprorelin, medroxyprogesterone acetate, megestrol acetate, paclitaxel, priority journal, progesterone, review, tamoxifen, treatment indication, tumor localization, tumor volume, unspecified side effect
Persistent URL dx.doi.org/10.1111/IGC.0b013e3181a7f71e, hdl.handle.net/1765/17148
Citation
van Wijk, F.H, van der Burg, M, Burger, C.W, Vergote, I, & van Doorn, H.C. (2009). Management of recurrent endometrioid endometrial carcinoma: An overview. International Journal of Gynecological Cancer, 19(3), 314–320. doi:10.1111/IGC.0b013e3181a7f71e