How would you manage an elderly but otherwise healthy patient with a high grade endometrioid uterine cancer with micro metastasis to a SLN, but otherwise confined to the uterus with superficial myometrial invasion?
Answer from: at Community Practice
With sentinel lymph nodes, pathology can show isolated tumor cells, micro metastasis, or macro metastasis. Our tumor board definitely has debated on how to handle micro metastasis in any patient, but especially those that are elderly, have treatment limited by social determinants, or have to travel ...
I would treat this patient with carbo/taxol x 6 cycles +/- vaginal brachytherapy. As Dr. @Tracilyn R. Hall stated, there is no high quality data to inform treatment in this situation. I agree there is a subset of otherwise low risk patients who can be observed in the setting of ITCs, but in the sett...