Would you offer systemic chemotherapy to a patient with at least 2023 FIGO stage IC high grade serous (p53-mut) endometrial cancer with extensive LVI for whom nodal assessment was not done?
Would you offer additional adjuvant treatment (e.g., pelvic EBRT, vaginal brachytherapy, etc.)?
Answer from: at Academic Institution
This question was addressed in a large NCDB study in 2020 by Nasioudis et al (Nasioudis et al., PMID 32675056) who looked at USC confined to the endometrium, which found that 5-year OS was 91% for chemo alone, 91% for chemoRT, 85% for those who received radiation alone, and 82% who were observed. Ad...
Answer from: Radiation Oncologist at Academic Institution
To recap for those (including myself) who are not routinely using FIGO 2023 staging at the current time - Stage IC uterine cancer is defined as: "Aggressive histological types limited to a polyp or confined to the endometrium."Given there was no MMI, NCCN does allow for consideration of VCB alone (w...
Answer from: Radiation Oncologist at Community Practice
Was preoperative imaging obtained? Why wasn't nodal assessment done? Could it be done if there are concerning findings on imaging?
If there are suspicious nodes on preoperative imaging (post-operative has to be taken with a grain of salt), I would treat with EBRT following chemotherapy if lymphaden...
Comments
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at University of Alabama at Birmingham RE: "Chemotherapy does cover the nodes compared to...
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