Treatment of Endometrial Cancer with Peritoneal and Lymph Node Relapse

Recurrent disseminated endometrial carcinoma — including spread to the peritoneum and lymph nodes — represents a clinically distinct scenario that requires careful individualized assessment before any intervention is planned.

Clinical scenario

This protocol addresses patients with endometrial carcinoma that has relapsed in a disseminated pattern, encompassing peritoneal involvement and lymph node disease. The extent and pattern of relapse, alongside the patient's overall condition and quality of life, are central to the management decision.

Approach overview

Surgical resection may be considered — but only under specific circumstances. When surgery is not an option, systemic therapy comes into focus as the primary approach. Palliative interventions, both surgical and radiation-based, have a role in selected cases where symptom control is the priority.

The structured protocol defines the criteria, sequencing, and conditions under which each modality is appropriate in this setting.

Instant Access to Structured Evidence-Based Regimens

References

In recurrent disseminated disease (including peritoneal and lymph node relapse), surgery should only be considered if complete macroscopic resection is feasible with acceptable morbidity and quality of life.
Systemic therapy or radiotherapy should be considered postoperatively, depending on the extent and pattern of relapse and the amount of residual disease (IV, B).
If surgery is not feasible, systemic therapy should be considered.
Palliative surgery can be done in selected cases to alleviate symptoms (eg, bleeding, fistula, or bowel obstruction; IV, B).
Palliative radiotherapy is indicated for symptoms related to pelvic or systemic disease (IV, A).

DOI: 10.1016/S1470-2045(25)00167-6

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