Operative treatment of endometrial cancer

Surgery is the therapy of choice in the primary treatment of patients with endometrial cancer. With the rising incidence of obesity, the number of patients with endometrial cancer will also increase. However, operations in obese patients are more challenging. Laparotomy as standard therapy in patients with endometrial cancer stages I and II should be replaced by laparoscopic approaches. Laparoscopy is oncologically equivalent to open procedures and offers many advantages to patients, especially those with relevant comorbidities. Robotic surgery for endometrial cancer is still under evaluation. The most controversial point of treatment today is the indication for and extent of lymphadenectomy in different stages. In advanced tumor stages, optimal debulking should be performed to improve the effectiveness of adjuvant chemotherapy and/or radiation therapy.