How do you approach endometrial cancer in the setting of multiple pelvic lymph nodes with ITCs and/or micromets, but no macrometastasis?

We are still learning how best to manage these patients as limited data suggests their outcome is much better and not the same as macromets. One caveat is that if only SNLN done with no dissection, than the data suggest there is risk of additional nodes which could be more than 20 percent and would then favor EBRT. But if full dissection is done, then the discussion is different and one may consider brachy alone if all other factors are favorable