What is your approach to the adjuvant treatment of early-stage mixed-histology endometrial cancer with a significant clear-cell component?

Clear cell carcinomas are under-represented in most clinical trials and hence, clear evidence-based recommendations are difficult to make. Even a small percentage of clear cell is sufficient to label these as “high grade”. The recently published ASTRO guidelines mention that chemotherapy may not ben...

I would treat a mixed histology with a significant clear cell component as a clear cell carcinoma. For patients with clear cell carcinoma, I tend to favor adjuvant RT over chemotherapy given the relative lack of response to chemotherapy for patients with a clear cell histology and metastatic disease...

I treat as I would early-stage clear cell cancer simply because the clear cell component would drive the prognosis even if that component is not significant. I give platinum-based chemotherapy followed by brachytherapy.