How do you manage early stage I uterine serous carcinoma?

The management of these patients remains controversial. The data are conflicting and treatment choices tend to be based more on impressions than solid data. Most clinicians advocate chemotherapy although randomized trials have not clearly shown benefit for this subset. For stage IA, we typically treat with cuff RT + chemo or, for patients who are elderly or frail who have minimal or no invasion, with cuff only. Our experience has suggested a higher rate of distant failure than the Canadian serie...

At present for surgically staged serous ca of endometrium, my philosophy is to treat like Grade 3 endometroid when deciding about radiation.

As far as chemo, most gyne oncs would give adjuvant chemo irrespective of stage, although the recent GOG 249 presentation did not see a benefit of chemo for stage II and II with papillary serous histology.

For stage IA with myometrial involvement, we treat with brachy alone. For stage IB and above, we discuss EBRT plus brachy.

For stage IA confined to a pol...

Based on GOG 249, is it very reasonable to treat stage I or II uterine serous carcinomas, with negative peritoneal cytology, with pelvic radiation alone?

Thank you