What is your adjuvant therapy approach for stage II endometrioid endometrial cancer?

For patients with stage II endometrioid endometrial cancer, there are several considerations for adjuvant treatment. I recommend using the NCCN guidelines to guide your patient's case when possible. If there is visible tumor involvement of the cervix prior to surgery, I will perform a radical hysterectomy to achieve negative margins, otherwise, I perform a standard extrafascial hysterectomy and staging surgery with sentinel lymph node dissection. If there is microscopic involvement of the cervical stroma found on final pathology with negative margins, I will recommend adjuvant radiation, usually with external beam radiation and vaginal brachytherapy. This is based on larger clinical trials showing benefit with adjuvant radiation in the sett...