Combined therapy for endometrial carcinoma: Preoperative intracavitary irradiation followed promptly by hysterectomy

Abstract

A group of 99 patients with endometrial cancer clinically confined to the uterus has been treated with preoperative adjunctive intracavitary irradiation followed within 72 hours by total abdominal hysterectomy and bilateral salpingooophorectomy. Those patients with poorly differentiated tumors, deep myometrial invasion, cervical involvement, or pelvic metastases were then considered for external beam radiotherapy to the whole pelvis because of the increased risk of involvement of pelvic nodes or other pelvic structures. Only one of 16 patients so treated has failed in the pelvis. The overall Berkson-Gage actuarial survival at 3 years, uncorrected for death from intercurrent disease, is 85.8%. No vaginal recurrences have been identified. Although this series has not been randomized, it appears that there has been a reduction in vaginal and pelvic recurrences when compared with patients reported by others who have received no adjuvant radiotherapy. The low recurrence rate and favorable survival in this group of patients was achieved with low morbidity from this treatment technique.