Clinical experience in gynecological cancer management. Endometrial cancer: report from the gynecological institutes of Padua university (1963-1989).

A complete review of case series from 1963 to 1969 (603 patients) permits some considerations and conclusions on the clinical management of endometrial cancer. In the aims of prophylaxis, prevention and early diagnosis, personalized, not routine mass screenings, are the best in clinical practice by gynecologists. Surgical Pathological Staging (SPS) is mandatory for adequate treatment and prognosis. Operability is now 96%, with surgical pathological radicality in 98% of operated patients. In early stages lymphnode involvement was low (5%), in advanced, high (31%). In uterine cancer the simple surgical exploration, when negative, is reliable in 90.9% for parametrial and 89.9% for lymphnodal status; consequently in early stages surgical exploration can lead to pelvic lymphadenectomy, or not. Simple surgical operations are almost always enough for good radicality, while enlarged operations must be personalized only in particular advanced cases. Five-year survival is better with surgery alone in the early stages (SPS A1-A2) rather than surgery plus integrated therapies. On the contrary, in advanced stages limited to the corpus uteri (SPS A3) surgery plus integrated therapies gives the best results in 5-year survival rates. In advanced cases growing outside the corpus uteri (SPS B) both surgery alone and surgery plus integrated therapy are disappointing, and the 5-year survival is the same. The incidence of vaginal cuff relapses is the same, with or without complementary radiotherapy, which we have abandoned. Close follow-up allows for the early treatment of relapses, improving quality of life and survival.