Is there a role for elective para-aortic nodal irradiation in endometrial cancer?

We treat in two scenarios:

One is for patients who have had surgery done, have positive pelvic nodes on pathology, and PA nodes have not been dissected. For these patients, surgical series report a risk of pa nodal involvement of 40-50% and we treat pelvic and PA region after adjuvant chemotherapy.

The other scenario is patients with locally advanced endometrial cancer (involvement of cervix and/or parametria) who are treated with preoperative chemoradiation at our institution. In these patients, ...