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Q. My mom had hysterectomy for adenocarcinoma. Is radiation therapy compulsory?

Answered by
Dr. Kumar Varadarajan Senthil
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Nov 19, 2017 and last reviewed on: Oct 09, 2018

Hello doctor,

My mother had complex endometrial hyperplasia for which surgery was fixed and last week, hysterectomy along with salpingo-oophorectomy and pelvic lymphonodectomy was done. After surgery, the parts were sent for histopathology. It was diagnosed as stage-2 endometrial adenocarcinoma. The lymph nodes were normal, uterus border was also normal and well-differentiated. Now, what is the treatment for this? Is radiation therapy required even after the removal of the entire uterus and its neighboring parts?

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#

Hello,

Welcome to icliniq.com.

  • It depends on the extent of disease within the myometrium and endocervical extent.

For further queries consult a medical oncologist online --> https://icliniq.com./ask-a-doctor-online/medical-oncologist

Thank you doctor,

I have attached the reports here.

#

Hello,

Welcome back to icliniq.com.

I have gone through your mother's reports (attachment removed to protect patient identity).

  • Brachytherapy (vaginal vault) alone will be the adjuvant treatment based on the following factors:
  1. Grade-1 tumor.
  2. Less than 50 percent myometrial invasion.
  3. The absence of lymphovascular invasion and complete surgical staging showing clear lymph nodes.
  • This is the current ESMO (European society for medical oncology) treatment guideline for a tumor with these features.

For more information consult a medical oncologist online --> https://icliniq.com./ask-a-doctor-online/medical-oncologist

Thank you sir,

I would like to know if surgery alone is not enough since it was grade-1 and it was within the uterus. Or, is radiation therapy compulsory?

#

Hello,

Welcome back to icliniq.com.

  • Your question is very valid. Yes, it was within the uterus and it had been removed. We are looking at reducing the risk of what people call as 'micro-metastasis' and it could happen in the vaginal stump (cut end of the operation at the back of the uterus).
  • Equally, the operation may have removed everything and there may be no cancer cell left behind in which case it may be an overtreatment. But, we do not have a crystal ball to predict that.
  • But, because of the age, I would mitigate the risk with vault brachytherapy.

For more information consult a medical oncologist online --> https://icliniq.com./ask-a-doctor-online/medical-oncologist


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