How do you counsel patients regarding adjuvant therapy for stage IA uterine serous carcinoma confined to a polyp?

Observation, if fully staged is acceptable. Consider that, in the case with no residual we recommend no chemo. So, if this patient had a hysteroscopic polypectomy and then hyst with no residual we would say no chemo but, the same patient, no polypectomy, we say chemo? Biologically, are the same.

First, one needs to be sure that a full staging procedure was performed, including peritoneal biopsies, omentectomy, and either successful bilateral pelvic sentinel lymph node sampling or full pelvic and paraaortic lymphadenectomy to confirm that the patient truly has stage IA disease. Because of the high risk of recurrence even with no myometrial invasion, NCCN guidelines state that the preferred option for therapy is adjuvant chemotherapy with or without vaginal cuff brachytherapy. This is the approach that we would take at Vanderbilt - preferably paclitaxel and carboplatin for 6 cycles with vaginal cuff brachytherapy between cycles 3 and 4 since the vaginal cuff is the most common site of recurrence. The only situation in which I would n...

Dr. @Dr. First Last and Dr. @Dr. First Last - In 2025, the same patient, would you do something different? Would you measure POLE (if p53 is mutated)?