Surgery for endometrial cancer: what type and by whom?

Endometrial cancer has far too long been regarded as a simple disease to tr eat. As such it has generally remained in the hands of the generalist obste trician/gynaecologist. In order to optimize the choice of surgery, careful pre-operative evaluatio n is essential with respect to pathology of a biopsy, radiological assessme nt of extent of disease and evaluation of fitness for anaesthesia. The standard procedure is a total abdominal hysterectomy and bilateral salp ingo-oophorectomy. However, consideration should be given to pelvic lymphad enectomy in high-risk cases. Surgery for high-risk endometrial cancer shoul d be performed by gynaecological oncologists.