Introduction/Background Patients with endometrial cancer of low risk (stage IA G1) are recommended for observation or adjuvant therapy (brachytherapy), as recommendations allow, on the basis of the presence of potential adverse risk factors such as: age, positive LVSI, tumor size, lower uterine segment or surface cervical glandular involvement.
The aim of this work was to revise low risk endometrial cancer patients that did not have adjuvant brachytherapy and developed recurrences in the context of their potential adverse risk factors.
Methodology Among 125 patients of stage IA G1 endometrial cancer, treated surgically in our centre (total laparoscopic hysterectomy with bilateral salpingoophrectomy and sentinel lymph node dissection or regional lymphadenectomy) with no adjuvant therapy between years 2012 and 2016, recurrences were noted in 2 cases (1,6%), as analyzed below.
Results In both cases the recurrence occurred in the apex of the vagina.
In the first case the relapse happened after 13 months from primary treatment. Initial surgery was performed in a 62 year-old patient and revealed a G1 endometroid endometrial cancer superficially invading the myometrium, with surface endocervial cancerous implants.
In the second case the recurrence was discovered 16 months after surgery. The primary treatment was performed in a 64 year-old patient and pathologic evaluation described an endometroid G1 endometrial cancer in stage IA involving the lower uterine segment, with positive LVSI.
Both patients after receiving treatment have been now disease-free for 18 months.
The analysis of non-recurrent cases revealed presence of single or multiple potential adverse risk factors.
Conclusion A combination of potential adverse risk factors must influence the formation of a relapse in low risk endometrial cancer. A calculative score system should be applied to assess potential adverse risk factors and define indications for brachytherapy.
Disclosure Nothing to disclose.
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