Is Adjuvant Radiotherapy Effective in Intermediate-risk Surgical Stage I Endometrial Cancer?

Long Term Benefits of Post-surgical Adjuvant Radiotherapy Among Sub-population of Patients with Stage IB Grade 2 Endometrial Cancer

“…In contrast to published lack of an evidence concerning survival advantage related to postoperative radiotherapy in endometrial stage I cancer 3,[12][13][14] , the effect of postoperative radiotherapy on 5-year survival and locally-relapse free survival were significant in our study. Therefore our finding of better 5-year survival and locally-relapse free survival obtained among our patients with postoperative adjuvant radiotherapy in terms of overall as well as radiotherapy-specific results seem remarkable in this manner.…”

“…2 The standard treatment for patients with stage I endometrial cancer is surgery, consisting of peritoneal lavage for cytology, extra-fascial total abdominal hysterectomy and bilateral salpingo-oophorectomy (TAH+BSO) and dissection of pelvic and aortic nodes. 3 Intraoperative inspection and palpation of abdominal organs, including the diaphragm, liver, omentum, and pelvic and bowel peritoneal surfaces together with the pathological results form the optimal basis of future adjuvant therapy. 3 Recommendation for adjuvant therapy is determined by risk factors that affect local recurrence and death rates, such as stage, myometrial invasion degree, grade, lymphovascular invasion and patient age.…”

“…3 Intraoperative inspection and palpation of abdominal organs, including the diaphragm, liver, omentum, and pelvic and bowel peritoneal surfaces together with the pathological results form the optimal basis of future adjuvant therapy. 3 Recommendation for adjuvant therapy is determined by risk factors that affect local recurrence and death rates, such as stage, myometrial invasion degree, grade, lymphovascular invasion and patient age. 4 The National Comprehensive Cancer Network (NCCN) Practice Guidelines for Endometrial Cancer version 2000 recommended observation, vaginal brachytherapy (VBT), or pelvic RT with or without VBT as adjuvant therapy for patients with stage IA grade 3, stage IB grade 2, and stage IC grade 1 cancer.…”

“…5 However, the value of postoperative RT in the treatment of patients with stage I endometrial carcinoma is controversial due to a lack of data from randomized studies and the low relapse rate. 3 According to a systematic review and meta-analysis of 1770 patients from four randomised trials 6 as well as data from the ASTEC/EN. 5 radiotherapy trial 7 , adjuvant radiotherapy results in a small reduction in risk of isolated women with intermediate-risk and high-risk early-stage endometrial cancer.…”

“…Post-operative policy is still ambiguous, especially in some selected sub-group patients, such as medium-risk Stage IB, grade II patients. 3 Since the requirement of post-operative adjuvant radiotherapy among patients with stage I endometrial cancer is still a subject of debate, we aimed to present data on use of postoperative radiotherapy in endometrial carcinoma by evaluating potential risks and benefits of adjuvant radiotherapy in selected patients with intermediate-risk surgical stage IB grade II endometrial cancer. 10 In patients lacking pelvic lymph node dissection (PLND) as a component of surgical operation, staging was accomplished via the depth of myometrial invasion as well as total abdominal MRI confirming lack of extra-uterine disease.…”