Does Surgery Help Women With Advanced Endometrial Cancer?
- Abdominal Cancers Alliance
- 2 days ago
- 2 min read
Pham ENB, Horeweg N, van der Marel J, Nooij LS. Survival benefit of cytoreductive surgery in patients with primary stage IV endometrial cancer: a systematic review & meta-analysis. BJC Rep. 2024 Oct 8;2(1):76. doi: 10.1038/s44276-024-00084-4. PMID: 39516418; PMCID: PMC11523991.
What Did the Study Look At?
This research combined results from multiple published studies to find out whether cytoreductive surgery (CRS) — surgery that removes as much visible cancer as possible — helps women with stage IV endometrial cancer live longer. In stage IV, the cancer has spread beyond the uterus to other parts of the body.
Why This Matters
Stage IV endometrial cancer is rare and serious, and it can be hard to know whether aggressive surgery is helpful. Doctors and patients want good evidence about whether surgery that removes all visible cancer (called complete CRS) or almost all visible cancer (optimal CRS) leads to better survival when compared with surgery that leaves more cancer behind (incomplete CRS).
What Did the Researchers Do?
They looked at 12 published studies involving a total of hundreds of women with stage IV endometrial cancer who had cytoreductive surgery.
They compared overall survival — how long patients lived — between women who had complete or optimal CRS versus those whose surgery left significant cancer behind.
What Did They Find?
Women who had complete or optimal surgery tended to live longer overall than women whose surgery left behind larger amounts of cancer.
In studies that reported a clear comparison, survival after complete or optimal surgery was significantly better than after incomplete surgery — meaning that the chance of living longer was higher for women with more thorough tumor removal.
These benefits were seen even in women whose cancer had spread outside the abdomen or who had more aggressive cancer types.
What Does This Mean for Patients?
This research suggests that for women with advanced endometrial cancer, having the most complete surgery possible may be associated with longer survival compared with leaving behind larger amounts of visible cancer after surgery. However, it’s important to consider:
Stage IV endometrial cancer varies a lot between individuals, and not every patient is a candidate for this kind of surgery.
The analysis combined data from different small studies, and not all women will have the same risks and benefits from surgery.
Decisions about surgery should be made together with the cancer care team, considering the potential benefits, possible risks, and a patient’s overall health and goals.
Bottom Line
For people with stage IV endometrial cancer, research to date suggests that complete or optimal cytoreductive surgery may help improve overall survival when it is achievable — but it’s a complex choice that requires careful discussion between patients and their doctors.
