New surgical approaches to early-stage endometrial cancer

Endometrial cancer (EC) is the most common gynecologic malignancy in developed countries with an increasing incidence. It is usually diagnosed at early stage and surgical treatment generally yield excellent survival outcomes. Standard surgical treatment for early stage EC includes peritoneal washing, total abdominal hysterectomy and bilateral salpingo-oophorectomy with or without pelvic and paraaortic lymphadenectomy. However, the lack of univocal data on the value of peritoneal washing, pelvic/paraaortic nodes resection and type II radical hysterectomy in early stage EC had simplified the use of several surgical approaches. Actually, the minimally invasive techniques are widely accepted by many authors for treating early stage EC, and the classical laparoscopic one should be considered the gold standard. Further techniques include the vaginal surgery, the robotic, the single port and micro/minilaparoscopic approaches. Fertility sparing surgery is also a potential approach for younger patients in reproductive age.