Advanced and Recurrent Endometrial Cancer; current concepts of treatment

Endometrial cancer is the most common gynecological malignancy in Western Countries. In the United States approximately 39,000 cases will be diagnosed in 2007 and 7,400 deaths will occur. Women have a 2.6% lifetime risk of developing endometrial cancer and it accounts for 6% of all cancers in women (1). The incidence of endometrial cancer rises from 2 per 100,000 women per year under the age of 40 years, to 40-50 per 100,000 women per year after the age of 60 (2). In the Netherlands, it is the fourth most common invasive tumor in women after breast, colorectal and lung cancer. Its incidence is still rising; 1,619 new cases of endometrial cancer were reported in the Netherlands in 2003, compared to 1,293 new cases in 1989 (www.ikcnet.nl). This increase is related not only to higher life expectancy but also to the exposure of the uterus to unopposed estrogens, either exogenous or endogenous as in obese patients.