Management of stage I carcinoma of the uterus

In an attempt to limit the use of adjuvant irradiation in the management of stage I endometrial carcinoma to high-risk patients only, a protocol was developed that utilizes grading and degree of myometrial invasion as indicators of high risk. From 1974 to 1977, 140 patients at Rochester General Hospital were treated according to this protocol. All patients had total abdominal hysterectomy and bilateral salpingooophorectomy. Adjuvant irradiation was given only to the patients who had grade 3 curettings or greater than one third myometrial invasion. In this series only 20.7% required irradiation. There were no vaginal or pelvic recurrences and the 5-year tumor-free survival rate was 93%.