How do positive pelvic washings influence your decision to administer adjuvant therapy to early stage endometrial cancer who otherwise meets no criteria for adjuvant therapy?  

<60y/o, grade 1 endometrioid endometrial cancer. TLH, BSO, sentinel nodes. Stage IA, focal LVSI, 20% myometrial invasion, negative sentinel nodes, positive pelvic washings.    Positive pelvic washings are an adverse prognostic sign in patients with other high-risk features. This patie...

Long-debated issue. Patients with positive washings and other high-risk factors do have a worse prognosis. Patients with no other risk factors, as presented here, may have no clear-cut diminution of survival, but I would tend to treat, given our inability to “salvage” as in “save&r...