Does size influence your decision making for women with low or low-intermediate risk endometrial cancer after hysterectomy?

Topics: Radiation Oncology • Gynecologic Cancers

More recent Italian (Sozzi et al) and French data (Canlorbe et al) show associations of greater tumor size > 25-35mm with higher rates of local & regional recurrence.

The ASTRO 2014 (Klopp et al) & ASCO 2015 (Meyer et al) guidelines don't appear to address tumor size which is understandable since classic prospective data such as GOG 99 and PORTEC-1 did not include tumor size as a risk factor.

Also, Mayo Clinic (AlHilli et al) published a nomogram predicting for nodal mets including tumor size as a factor. Is there a similar nomogram in the works for predicting vagina cuff recurrence including tumor size as a factor?

References:

Sozzi et al: https://www.ncbi.nlm.nih.gov/pubmed/29489475

Canlorbe et al: https://www.ncbi.nlm.nih.gov/pubmed/25952272

Klopp et al: https://www.ncbi.nlm.nih.gov/pubmed/24766678

Meyer et al: https://www.ncbi.nlm.nih.gov/pubmed/26150442

AlHilli et al: https://www.ncbi.nlm.nih.gov/pubmed/23845691

Answer from: Radiation Oncologist at Community Practice

In otherwise low risk disease where I would favor observation, I do discuss pros and cons of adjuvant cuff brachytherapy if size greater than 2.5 cm or so.

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