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Does lymphovascular invasion trump POLE mutation in early-stage uterine cancer adjuvant therapy decisions? Would you offer brachytherapy?
73F with FIGO 2018 IA2/FIGO 2023 IAmPOLEmut, grade 2 uterine-confined endometrioid carcinoma with 33% myometrial invasion, > 5 foci of LVSI, POLE-mutated, MMR intact, p53 normal, sentinel nodes negative.
Answer from: Radiation Oncologist at Community Practice
In the current ESGO guidelines, stage I and II POLE types are always low risk, irrespective of substantial LVSI, with a predicted risk of recurrence being less than 10 percent, and favoring observation. That being said, in practice, I do offer brachytherapy, as I feel it is a low morbidity procedure...
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