Analysis of carcinoma of the endometrium treated with post operative radiotherapy

An audit was carried out of post-operative radiotherapy given for carcinoma of the endometrium at the Christie Hospital between the years of 1984-86. 139 patients were treated following total abdominal hysterectomy (TAH) and bilateral salpingo-oophorectomy (BSO). 54 patients were treated with vaginal brachytherapy alone, 55 had pelvic brick external beam irradiation and 30 patients had both external beam irradiation and vaginal brachytherapy. Overall survival was 84% at 5 years, with a 5.8% local recurrence rate. Histological grade was a prognostic factor for survival (p=0.023) and relapse (p=0.002). Tumour stage was a significant prognostic factor for survival (p=0.011), but not relapse. Survival for stage IB disease was 100% at 5 years with no local recurrence. Major treatment related morbidity was 1.4%, overall; for vaginal brachytherapy alone 0%; for external beam therapy 2%; and combined therapy 3%. Given their good prognosis, and the small but definite risk of major morbidity, patients with stage IB disease may not need postoperative external beam irradiation.