Do you follow GOG, ASTRO, or PORTEC recommendations for adjuvant therapy in stage I endometrial cancer patients?
I believe the current ASTRO guidelines encompass the older GOG and PORTEC guidelines for the most part and we follow these guidelines though we review all for the sake of completeness.
For the first patient, barring other risk factors, I would offer adjuvant vaginal cuff brachytherapy; for the second...
I tend to follow both. Essentially, if the patient meets either GOG or PORTEC criteria to be classified as high intermediate risk endometrial cancer, I would offer that patient adjuvant treatment with vaginal brachytherapy.
I think these designations of risk groups are a useful place to start, but none of them tell the whole story of risk. I prefer assessing all of the known risk factors together and making an estimation of vaginal or pelvic recurrence using GOG 99, PORTEC-1, and PORTEC-2 data as starting points. Even ...
I apply treatment per individual cases using 3 guidelines but additionally investigate not only pathology but also genetically mutated cells for mismatch repair gene. This will guide me further to manage the patient for additional treatment radiation. Low-grade tumors and stage 1b-1 without LVSI wil...
I use all the 3 guidelines depending on the specific treatment scenario.