When is it appropriate to use adjuvant whole pelvis radiotherapy for Stage I endometrial adenocarcinoma?

The indications have been changing with the publications of GOG 99, PORTEC 1 and 2 , the Swedish and ASTEC studies, and the interpretation of data with the confounding factor of nodal dissection.

At present, I would/do consider pelvic RT for Stage IB with grade 3 disease and Stage Ia with grade 3 and LVSI .

The anticipated presentation of GOG 249 in the upcoming SGO meeting comparing pelvic RT to brachy plus chemo may further help in defining indications.