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#680 Pelvic recurrence following adjuvant vaginal brachytherapy for stage I/II non endometrioid endometrial cancer
  1. Andrew Wilkinson,
  2. Laura Hannington,
  3. Azmat Sadozye,
  4. Claire Duncanson,
  5. Rosie Harrand,
  6. Ashleigh Kerr and
  7. Kathryn Graham
  1. Beatson West of Scotland Cancer Centre, Glasgow, UK


Introduction/Background Stage III endometrial cancer is managed with surgery and adjuvant chemoradiotherapy. The optimal treatment for Stage I/II high risk disease remains controversial. Here, we evaluated frequency and site of first relapse following adjuvant vaginal brachytherapy for FIGO Stage I-II endometrial cancer with non-endometrioid histology.

Methodology The central radiotherapy prescribing system at our institution was interrogated to identify patients who commenced vaginal brachytherapy, 2100cGy/3#, for endometrial cancer, 1st January 2017 to 31st December 2019. Only those with Stage I-II disease and non-endometrioid pathology were included. Clinical follow up was undertaken until death or 5 years had elapsed (data lock 31st December 2022).

Results In total, 68 patients were identified. Median age was 69 years (range 47–92) and median follow up was 33 months . FIGO 2018 Stage: IA (54.4%); IB (20.6%); II (25%). Pathology: serous (60%); carcinosarcoma (22%); clear cell (12%); undifferentiated/mixed (6%). Pelvic lymph node dissection (PLND) was performed in 50/68 (74%) and lymphovascular invasion (LVSI) was present in 25/68 (37%). Adjuvant chemotherapy (Carboplatin AUC5/Paclitaxel 175mg/m2) was delivered to 11/68 (16%) patients; median number of cycles - 4 (range 2–6). By study end, 23/68 (34%) patients had relapsed and 17/68 (25%) had died. Relapse frequency based on clinical/pathological characteristics: pathology (serous - 16/23, other - 9/23), stage (IA/B - 11/23, II - 12/23), LVSI (yes - 13/23, no – 10/23), PLND (yes – 17/23, no – 6/23), chemotherapy (yes – 5, no – 18).Pattern of relapse: pelvis only - 6/23 (26%), distant only - 4/23 (17%), both pelvis and distant – 13/23 (57%). Overall pelvic failure rate was 19/68 (28%).

Conclusion Pelvic recurrence rate was almost 30% despite adequate nodal staging and negative LVSI in >60% of cases. External beam radiotherapy should be strongly considered in early stage non-endometrioid pathology to improve loco-regional control.

Disclosures None

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