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How do you approach adjuvant radiation recommendations for low-risk endometrial cancer in which the patient was unable to undergo pelvic sentinel node mapping?

For example, for a patient in their 60s with stage IA, pT1a, N0 endometrioid endometrial cancer, s/p TAH/BSO, showing grade 2, 1/17 mm invasion, single focus (3 mm) of LVSI, no lower uterine segment or cervical stroma involvement.
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Which radiation treatment option would you recommend in low-risk endometrial cancer in which the patient was unable to undergo pelvic sentinel node mapping?

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2 Answers
Mednet Member
Mednet MemberInvited Expert
Radiation Oncology · Varian Medical Systems/Allegheny health network
Answered on

Nodal assessment would not change much for me, as it’s a low-risk disease, and PORTEC data have shown the risk of nodal recurrence is low. For focal LVSI, one may consider brachy alone.

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Mednet Member
Mednet MemberInvited Expert
Radiation Oncology · Varian Medical Systems/Allegheny health network
Answered on

Nodal assessment would not change much for me, as it’s a low-risk disease, and it would not also change the outcome or treatment recommendations.

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