Benefit of adjuvant radiotherapy in surgically staged stage I-II endometrial carcinoma

Aims and background: This study was performed to determine the treatment ou tcomes and patterns of failure following external beam therapy in patients with pathological stage I-II endometrial carcinoma. Study design: Eighty-three patients with stage I-II endometrial carcinoma s urgically staged who were found to have high risk factors and who received postoperative radiation therapy are the subject of this report. High risk f actors were: histologic grade II-III, depth of myometrial invasion (DMI) gr eater than or equal to 1/2, stage II, poor prognostic histology (clear cell , papillary serous cell) and lymphovascular invasion. Results: Recurrences were observed in six patients. The recurrences were lo cated in the vagina (1), lung 12), liver (1), and paraaortic lymph nodes (1 ). Five of the six recurrences were stage IC and II. The overall survival ( OS), cause-specific survival (CSS) and disease-free survival (DFS) at five years were 82.9%, 85.0% and 81.3%, respectively, DMI, grade, age and cervic al stromal invasion had a significant impact on CSS. Conclusion: Adjuvant radiotherapy decreases the rate of relapse in patholog ically staged high-risk stage I-II endometrial carcinoma patients. After re viewing the other studies on this subject we conclude that vaginal cuff bra chytherapy alone could be used in stage IA grade III and stage IB grade I-I I patients because the recurrence rate is low; pelvic radiotherapy + vagina l cuff brachytherapy should be used for stage IC-II disease. Distant metast ases occurred in five of our patients and represent a significant type of f ailure.