Operative treatment in stage I endometrial carcinoma with deep myometrial invasion and/or grade 3 tumor surgically limited to the corpus uteri. No recurrence with only primary surgery.

A prospective study was conducted to determine the effectiveness of primary surgical treatment without postoperative irradiation for patients with Stage I endometrial carcinoma possessing poor prognostic factors of deep myometrial invasion and/or histologic Grade 3 tumor, in whom no evidence of cancer spread was detected outside the corpus uteri at the time of staging laparotomy. All 18 patients who had only surgical treatment and cancer limited to the corpus uteri showed no evidence of disease in follow-up of 5 to 13 years. Only 26.7% (four of 15) patients with cancer spread beyond the corpus were disease-free. From these preliminary results, it is concluded that in patients with Stage I endometrial cancer who had no extracorporal spread upon adequate surgical staging, even with poor prognostic factors of deep myometrial invasion and/or Grade 3 tumor, postoperative radiation might not be necessary.