What is optimal therapy for a 5 year delayed recurrence of uterine cancer, rendered NED by solitary pulmonary metastasis resection?

I favor “pseudoadjuvant” therapy with carboplatin + paclitaxel chemotherapy for 6 cycles. I make this recommendation in the absence of strong data to suggest an improvement in outcome with chemotherapy over observation vs. hormonal therapy.

The optimal therapy for this patient with recurrent endometrial cancer rendered NED after resection of a solitary lung metastasis is not known. Case reports of gynecologic cancer patients with oligo-metastatic disease after a long disease-free interval describe long-term survival with multi-modality management.^1,2,3,4 It is uncertain whether these “cures” or prolonged survival are related to favorable disease biology versus aggressive local and/or systemic interventions or both.

Oligometastatic Disease in...

Over the years, I have had several patients like this and after pulmonary resection, have just followed them without further therapy and to date no recurrence.

Not much data is available. Consideration of adjuvant therapy, in this case, depends on a number of factors. In a very elderly and frail patient, I would agree with Dr. @Dr. First Last and manage expectantly without any active treatment. In others, I would check ER/PR status and if positive, would treat with progestins. This is a fairly easy regimen and will maintain the patient’s QOL. If the disease progresses, then you still have the opportunity to treat with cytotoxics.

Can also consider enrolling the patient into GOG-3041.