Is adjuvant treatment recommend for a 0.8cm serous endometrial CA confined to polyp s/p hysterectomy + surgical staging?

For surgically staged IA confined to polyp, the risk of recurrence reported in literature varies but on average, appears to be low and recent ESGO guidelines favor no treatment.

The NCCN guidelines prefer cuff brachytherapy for all stage IA non-invasive serous endometrial cancers which is my general practice. I advocate for vaginal cuff brachytherapy regardless of MMI given the minimal treatments and well tolerated nature of it. Our previous NCDB analysis (with all the caveats of NCDB) showed that brachytherapy helped even in a subset of patients without myometrial invasion (Shinde et al., PMID 30170976).

Most of the serous patients end up at least trialing chemotherapy as well given known benefit in serous cancers (albeit stage I-III) per post-hoc analysis of PORTEC-3 (de Boer et al., PMID 31345626), although NCCN has recently removed this in favor of pelvic washings guiding treatment. The discussion of at least st...