For the patient with curable endometrial cancer, surgery remains an essential ingredient for success. Because treatment has been fairly stable for years, it has tended to be stereotyped. Though the programs are generally successful, there is still not adequate recognition of various surgically based categories of risk in applying treatments. Preliminary observations from a current surgical staging study of the Gynecologic Oncology Group suggests that such operative procedures carried out as part of primary definitive therapy can play a meaningful role determining risk that would influence the planned treatment.
Cancer 48568-574. 1981.
EMOVAL OF THE UTERUS has been for decades a R fundamental aspect of endometrial cancer cure.
The idea expressed by many patients in their query "Why don't you just cut it out?" appeals to lay and professional persons dike. It is just the techniques employed, the extent of surgery and the adjuvant procedures have varied. The fact that surgery is the basic means for definitive therapy for Stages I and I1 cancer means that over 70% of patients are eligible for treatment by some variant on hysterectomyss and that 65% to 75% of the operable patients can expect to be free of disease at five year^.^^^^^^^,^^^^^^^^,^^^^^,^^ It appears from current investigations that surgery's contributions in diagnosis, prognosis and definitive therapy are being modified and expanded.
Although surgery was the first major modality to significantly control endometrial cancer, its general applicability, especially as a single procedure, was very restricted, until the 1950s when adequate blood banking, improved anesthesia, antibiotics and other supportive measures changed the picture. By the time intracavitary radiation was introduced in 1919 in New York City at Women's H o ~p i t a l , ~~, ~~ it was apparent that surgery alone could not deal with all problems, and