WHAT IS THE PROPER WORK-UP OF THE PATIENT WITH CLINICAL EARLY STAGE UTERINE ADENOCARCINOMA?

Cancer of the uterine corpus is the most common invasive pelvic gynecological malignancy in the United States and other industrialized nations, and as a “female” malignancy is exceeded in incidence only by breast cancer. Compared to other pelvic cancers, a greater percentage of patients initially present with disease apparently confined to the uterine corpus (clinical Stage I under the older International Federation of Obstetrics and Gynecology [FIGO] system), in large part because the vast majority of patients with uterine adenocarcinoma first present with abnormal or postmenopausal bleeding and are promptly evaluated and treated. Surgery remains the cornerstone of the initial management for almost all uterine cancer patients. Despite the relatively high incidence of uterine cancer in industrialized nations and the nearuniversal agreement that the initial therapy of such patients will be hysterectomy with some degree of surgical staging (reflecting the fact that the current FIGO staging of uterine adenocarcinoma is now a surgical, not clinical, staging), there is no definitive literature or consensus about what the “proper” preoperative workup should be for the most common WHAT IS THE PROPER WORK-UP OF THE PATIENT WITH CLINICAL EARLY STAGE UTERINE ADENOCARCINOMA? Bruce Patsner, MD, JD, Matthew L. Anderson, MD, PhD Department of Obstetrics and Gynecology, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea; Division of Gynecologic Oncology, Department Obstetrics and Gynecology, Clinical and Translational Research, Baylor College of Medicine, Houston, TX, USA