Postoperative radiotherapy in the treatment of adenocarcinoma of the endometrium in pathological stage I

: We report on 49 patients with pathologic stage I endometrial adenocarcinoma who underwent postoperative whole-pelvis irradiation (RT) (45-50 Gy in 5-6 weeks) from November 1981 to December 1988. RT was performed when one or more of the following unfavorable prognostic factors were discovered: myometrial infiltration greater than 1/3 (42 cases, or 85.7%), poorly-differentiated tumor (10, or 20.4%), tubaric angles involvement (4; or 8.2%), pelvic nodal metastases (1, or 2.0%). Five-year actuarial disease-free survival was 91.4%. After an average follow-up of 58 months, we observed recurrent disease in 4 patients (8.2%) (3 cases with distant metastases, 6.1%; 1 case with vaginal relapse, 2.0%). All recurrences were observed within 18 months from treatment and occurred only in patients with both myometrial infiltration greater than 1/3 and poorly or moderately differentiated tumor. The patient with vaginal relapse had a complete response after endocavitary curietherapy, but died later on from lung metastases. None of the treated patients experienced severe complications related to the treatment. Our results are comparable with those of the most recent literature, and confirm the good tolerance and efficacy of postoperative RT to prevent loco-regional relapses in early stage endometrial cancer with unfavorable prognostic factors.