Vol. 8, Issue 3, Part D (2022)

Abstract
Background: The role of adjuvant radiotherapy in Stage-1 endometrioid adenocarcinoma is still controversial. This study is an analysis of outcome and patterns of failure associated with adjuvant treatment strategy followed at our centre and the implications for radiotherapy.Material and Methods: The demographic, surgical, pathological and adjuvant treatment details of 140 patients operated between 2008 and 2013 having FIGO Stage-1 endometrioid adenocarcinoma was analyzed. The risk- stratification was done according to ESMO guidelines.Results: Ninetytwo (66%) of the patients were categorized as low risk, 39(28%) as intermediate risk and 9(6%) as high risk group. 57(41%) underwent pelvic lymphnode dissection. In the low risk group 68(74%) patients received no adjuvant treatment .In the IR group 20(51%) received Pelvic EBRT, 16(41%) received both pelvic EBRT & VBT. Among the high risk group, out of nine patients 4(44%) received Pelvic EBRT, another 4(44%) received both (EBRT & VBT). There were 9(6.4%) recurrences. The 5 year-DFS(95%) was similar among the LR and the IR group .The Grade1 & Grade2 late bladder toxicity was seen in 6(10%) and 3(5%)patients .Grade1 and Grade2 late GI toxicity developed in 9(15%) and 4(6%) respectively. The Grade2 and Grade3 vaginal stenosis occurred in 4(6%) and 2(3%) patients respectively.Conclusion: The most consistent factor associated with relapse appears to be advanced age and postmenopausal status. Adjuvant radiotherapy prevented local recurrences and since surgical expertise is limited in India it should strongly be considered in the IR group. Individualized risk models are necessary to increase the predictive ability of current staging system.