How do positive pelvic washings influence your decision to administer adjuvant therapy to early stage endometrial cancer who otherwise meets no criteria for adjuvant therapy?

<60y/o, grade 1 endometrioid endometrial cancer. TLH, BSO, sentinel nodes. Stage IA, focal LVSI, 20% myometrial invasion, negative sentinel nodes, positive pelvic washings.

Positive pelvic washings are an adverse prognostic sign in patients with other high-risk features. This patient has low risk disease. I would not recommend treating based on pelvic washings alone. We know that endometrial cancer cells can efflux into the peritoneal cavity through the Fallopian tubes and that the incidence ...

Long-debated issue. Patients with positive washings and other high-risk factors do have a worse prognosis. Patients with no other risk factors, as presented here, may have no clear-cut diminution of survival, but I would tend to treat, given our inability to “salvage” as in “save” those with recurrent disease.