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How do you decide on adjuvant therapy in a patient with a Stage IA uterine carcinosarcoma without any myometrial invasion?

The NCCN recommends either systemic therapy + brachytherapy or pelvic RT + brachy or brachy alone or observation. How do you decide among these options? Does your recommendation change if there is invasion but < 50%?
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Radiation Oncology · Varian Medical Systems/Allegheny health network
Answered on · Updated on

There is no good prospective study. Our approach, based on outcome and retrospective data (including NCDB), is brachy plus chemo.

https://www.ncbi.nlm.nih.gov/pubmed/30170976

This is paper I was referring to. With all the caveats of NCDB studies, it givess some objective information where prospective...

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