How would you treat completed resected rectosigmoid recurrence of endometrial adenocarcinoma?
This patient previously received hysterectomy with adjuvant vaginal cuff brachytherapy without pelvic RT. Colonoscopy demonstrated invasive disease, biopsy-proven to be recurrent endometrioid adenocarcinoma.
Salvage surgery done with negative margins and end-to-end anastomosis, but +LVSI and mesorectal tumor deposits on final path. No evidence of vaginal cuff or regional node recurrence, on staging workup, and no visible extrapelvic disease.
2 Answers
Mednet MemberInvited Expert
Radiation Oncology · Varian Medical Systems/Allegheny health network
Answered on
We have equally treated with chemotherapy for recurrence followed by involved site with RT in a few cases for isolated extended pelvic relapse. Overall outcome has been mixed.
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Mednet Member
Radiation Oncology · Vanderbilt-Ingram Cancer Center
Answered on
This is technically stage IVB as presumably, the tumor had to go across the peritoneum to seed the external surface of the rectum, which then likely grew into the rectal mucosa. Unless, it is perhaps in a focus of endometriosis, which would likely still be staged similarly.
Adjuvant chemotherapy alo...
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