SURGICOPATHOLOGIC STAGING OF ENDOMETRIAL ADENOCARCINOMA

In 1988, the International Federation of Gynecologists and Obstetricia ns' (FIGO) staging criteria for endometrial cancer were changed to req uire that surgical observations be included in the staging process. St aging now requires thorough intraperitoneal and retroperitoneal search and documentation of metastatic cancer; in addition, direct uterine i nspection for tumor invasion and degree of cervical involvement replac e length of uterine cavity and endocervical curettage. With change, th ere have naturally been questions regarding the method, benefit, and r isk of surgical staging. The major concerns include: do all patients r equire surgical staging! what are the risk factors of endometrial canc er! what is gained from preoperative evaluation! what is the technique of surgical staging! what are the hazards to the patient! how is stag ing incorporated into treatment? and, what is the current experience w ith surgical staging! These questions are addressed in this review.