Adjunctive radiation therapy in the management of stage I cancer of the endometrium.

One hundred fifty-two patients with stage I, grades 2 and 3 adenocarcinoma of the endometrium, treated in 1972 and 1973 at the Radiumhemmet, are presented. Two uterine packings followed at 4 to 6 weeks by total abdominal hysterectomy and bilateral salpingo-oophorectomy resulted in a 5-year survival of 89%, whereas patients treated primarily with surgery followed by vaginal cylinder irradiation demonstrated 90% survival. Patients in both groups received whole pelvis irradiation postoperatively for deep myometrial invasion (more than 50% invasion by viable tumor). Patients treated with radiation therapy alone had 57% survival. Optimal results in poorly differentiated (grade 3) carcinoma of the endometrium were achieved with preoperative packings (90% survival); only 12% of the patients required external radiation therapy postoperatively.