Adjuvant pelvic radiotherapy has the potential to eradicate micrometastases within the irradiated field but has not resulted in survival improvements in randomized studies. This illustrates the need for systemic therapy. Chemotherapy, mainly with anthracyclines, platinum compounds, and taxanes, renders high response rates although this unfortunately translates in only modest improvements in progression-free and overall survival. Better systemic treatments need to be developed. Investigations of the molecular mechanisms of endometrial cancer have identified possible targets for therapy. In advanced endometrial cancer one study shows that chemotherapy is better than whole abdominal radiotherapy, while in the adjuvant situation the combination of chemotherapy and radiotherapy appears promising.