The value of adjuvant irradiation in the treatment of endometrial carcinoma stage I, group I

Four hundred ninety-seven cases of Stage I, Group I endometrial adenocarcinoma were treated by surgery alone (50 cases) or combined surgery and irradiation (447 cases). Radiation modalities used were uterine radium (327 cases), vaginal radium (30 cases), external pelvic irradiation plus radium (40 cases), and external pelvic irradiation alone (50 cases). The results of these different approaches were evaluated from the point of view of 5-year cure rates, relative morbidity, and incidence of recurrence. Clinical evidence of increased cure rate was seen in those receiving adjuvant irradiation, although the difference was not statistically significant. The most favorable results followed adjuvant uterine radium and adjuvant external pelvic irradiation plus radium. The difference in uterine depth did not influence she results. The degree of differentiation of tumor and myometrial invasion was of prognostic significance. Adjuvant irradiation improved the results in less differentiated tumor. The presence of residual tumor in the removed uteri after irradiation had little influence on the prognosis. The combined effects of surgery and irradiation were well tolerated with a low morbidity rate. A decrease in the incidence of recurrence followed the use of all forms of irradiation.