Would you recommend systemic therapy in a patient with a history of Stage III high grade serous endometrial cancer s/p resection of a solitary pulmonary metastasis after a long disease free interval?

Systemic therapy should be advised in this patient with recurrent serous endometrial cancer after surgical resection of oligometastatic disease and a long disease free interval. Before advising a specific therapy, pathologic review by an expert gynecologic pathologist for both histologic confirmation and evaluation of margin status for the excised pulmonary metastasis is advised. Serous endometrial cancer is an aggressive type of endometrial cancer, and disease recurrence after a 10-year disease...

I agree that a solitary pulmonary recurrence is unusual after a long disease free interval. I too would ensure a gynecologic pathologist review to confirm the diagnosis and pay close attention to margin status. I also agree that careful evaluation for any other sites of disease needs to done, preferably with a PETCT scan. I also would be sure to order some sort of molecular testing/PDL-1 evaluation/MSI testing to help understand the biology of her tumor as well as potential treatment options in ...