Would you change your approach to adjuvant radiation for an incompletely staged, at least IB, grade 1 endometrial cancer, if a uterine perforation occurred at time of surgery?

Similarly to the above authors, I agree with offering this patient vaginal brachytherapy.

Though she does not definitively meet GOG99 criteria, given the situation with deep myometrial invasion and perforation, this is a reasonable and low-risk treatment opportunity to decrease local recurrence.

The...

Agree with @Dr. First Last RE vaginal brachytherapy.

Our cancer patients are managed with SLNB for nodal evaluation, unless the initial pre-operative diagnosis is hyperplasia - then we discuss SLNB at the time of hysterectomy or use Mayo Criteria to guide surgical LN staging.

There is no robust data t...

Agree with the above comments. I do not think there is any evidence of uterine perforation and increased risk of local recurrence. Peritoneal cytology is no longer in the FIGO staging, and if anything this would be a chemotherapy-related issue, which this patient does not require. I would feel comfo...

There are 2 parts to this question:

First, is the incomplete surgical staging (by which I assume you mean no pathological lymph node assessment) problematic? The MRC ASTEC trial did not identify a benefit to lymphadenectomy in clinical stage I patients, so it would be reasonable to omit surgical lymp...

I ask myself and the patient, "What if we were here before the hysterectomy? Would we recommend surgical staging? If the answer is yes, then why not now, assuming you heal and have no major contra-indications?"

GOG 33 reported 11% pelvic node metastasis and 6% para-aortic metastasis for outer third g...