Surgery and postoperative radiotherapy in the treatment of stage I endometrial carcinoma

: From 1977 to 1985 160 endometrial carcinoma stage I patients were treated with total abdominal hysterectomy and bilateral salpingo-oophorectomy and postoperative irradiation. Hundred-thirty-one patients received postoperative pelvic telecobalt-therapy, total dose 45-50 Gy and 29 patients received postoperative endocavitary curietherapy (Cs137) to the vagina vault, total dose 50 Gy. Median follow-up was 5.6 years (range 3-11 years). Overall actuarial five-years disease-free survival was 89% +/- 2.7. For the group of patients treated with external radiotherapy and group receiving curietherapy 5-years D.F. survival was respectively 88% +/- 2.9 83% +/- 4.7. There is no statistically significant difference in survival time between the two groups (p = 0.688). There were no cases of vaginal recurrence (0%) and 2/160 cases (1.2%) there pelvic relapse. In 2/160 cases (1.2%) distant metastases occurred. Late I II grade effects were found in 15/160 cases (9.3%). Retrospective analysis of results and casuistry lead to the conclusion that radiotherapy must, in cases at risk, follow surgery in the treatment of stage I endometrial carcinoma with the aim of reducing the loco-regional relapses and increasing survival time.