Surgical Treatment, Prognosis

Treatment

Treatment for uterine cancer depends on the stage of the disease and the overall health of the patient. Removal of the tumor (surgical resection) is the primary treatment. Radiation therapy, hormone therapy, and/or chemotherapy may be used as adjuvant treatment (i.e., in addition to surgery) in patients with metastatic or recurrent disease.

Surgical Treatment
Treatment for uterine cancer usually involves removal of the uterus, including the cervix (called total hysterectomy), and removal of the fallopian tubes and ovaries (called bilateral salpingo-oophorectomy). Surgery may be performed through an incision in the abdomen or through the vagina (called transvaginal hysterectomy).

Postoperative pain, nausea and vomiting, and fatigue are common side effects of surgery. Patients may remain hospitalized for a few days to 1 week and usually can resume normal activities in 4 to 8 weeks. Complications include the following:

• Adverse reaction to anesthesia
• Hemorrhage (bleeding) caused by injury to surrounding blood vessels (e.g., artery, vein)
• Injury to surrounding organs (e.g., large intestine)
• Thromboembolism (blockage of an artery or vein by a blood clot)

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Surgery is curative in about 65% of cases of early-stage uterine cancer. Patients with tumors confined to the uterus are at low risk for recurrent or metastatic disease and usually do not require additional treatment. Follow-up care includes physical and pelvic examinations, x-rays, and blood and urine tests at 6 to 12 month intervals.

Prognosis

Prognosis depends on the stage of the disease and overall health of the patient. Cancer that is confined to the uterus can be cured surgically in 60–70% of cases. Metastatic uterine cancer and uterine sarcoma, which has a high rate of recurrence, carry a poor prognosis.

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