Endometrial cancer is the most common gynecological malignancy in high-income
countries. Although the overall prognosis is relatively good, high-grade endometrial cancers
have a tendency to recur. Recurrence needs to be prevented since the prognosis for
recurrent endometrial cancer is dismal. Treatment tailored to tumor biology is the optimal
strategy to balance treatment efficacy against toxicity. Standard treatment consists of
hysterectomy and bilateral salpingo-oophorectomy.Lymphadenectomy (with ongoing
studies of sentinel node biopsy) enables identification of lymph node positive patients who
need adjuvant treatment, including radiotherapy and chemotherapy. Adjuvant radiotherapy
is used for Stage I–II patients with high-risk factors and Stage III lymph node negative
patients. In advanced disease, a combination of surgery to no residual disease and
chemotherapy results in the best outcome. Surgery for recurrent disease is only advocated
in patients with a good performance status with a relatively long disease-free
interval.