Uterine epithelial cancers are the most common type of gynecologic cancer in the
United States. The American Cancer Society estimated 53,000 new cases of uterine cancers
in 2014 with 8,600 deaths from advanced or recurrent cases, 99% of which are endometrial
cancer. The 5-year survival rate of low-stage, low-grade endometrioid adenocarcinoma is
greater than 90%. In contrast, advanced stage endometrioid adenocarcinomas and Type II (serous and carcinosarcoma)
endometrial cancers have a much poorer prognosis, with the 5-year survival rate of advanced
stage uterine carcinosarcoma as low as 9%. Together, these endometrial cancers with poor prognoses comprise
almost half of all cases in the US, creating a significant medical obstacle for management. The authors
present a review of endometrial cancer pathology, diagnosis and treatment. Included on the topic of treatment
are: surgery, endocrine therapy, and chemotherapy with commentary on pertinent phase II and III clinical trials.
The discussion covers single and multi-agent chemotherapy. Also covered are current clinical trials using
targeted therapies such as mTOR inhibitors, angiokinase inhibitors, and HER2-directed agents. The review
concludes with thoughts on future directions in therapeutic management of this disease.
Keywords: Endometrial cancer, endometrioid adenocarcinoma, serous, carcinosarcoma, chemotherapy,
endocrine therapy, targeted therapy.
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