What adjuvant treatment would you recommend for a patient with FIGO 2023 IIIB2 endometrioid endometrial adenocarcinoma (Grade 3, p53mut, MMR proficient), metastatic to the uterine serosa, bilateral ovaries, and anterior peritoneal reflection?

Chemotherapy followed by pelvic RT

I don't routinely radiate these patients unless they are copy-number low/NSMP subset, in which case I give chemotherapy first and radiation.

These are the subset of patients in PORTEC-3 that benefitted from chemotherapy and based on GOG-0258, you can absolutely omit radiation. If this patient was sta...

For this patient, I would just give cuff brachy between cycles 1-2 if adequately healed, as with peritoneal and ovarian disease patterns of failure don't support EBRT in my eyes.