Indication for radiotherapy in carcinoma endometrium include all except
Ans. is 'c' i.e. Enlarged uterine cavity A general rule tends to be followed in the case of the t/t of carcinoma endometrium.Tumours with good prognosis can be treated with surgery alone whereas radiotherapy is required in cases with poor prognosis.Several prognostic factors have been shown to correlate with treatment outcome.Histological differentiationAs the tumour loses its differentiation the chances for survival decreases.There are more chances of lymph node involvement in cases of undifferentiated tumours.Cervical involvementPrognosis is worse with cervical involvement.Management of uterine carcinoma STAGE ITotal abdominal Hysterectomy + Bilateral salpingoophorectomy Radiotherapy is done in:Stage IAG3,IBG3Stage IC, G1-G3Patients who have vaginal cut margin, adnexa or pelvic node metastasic STAGE II (Tumor invades the stroma)Total abdominal hysterectomy + B/L salpingoophorectonmy + Post operative radiotherapy (If the patient has clear out stromal invasion, the patient should be advised to undergo Wertheims hysterectomy)STAGE III (Tumor involves serosa, adnexa and lymph node)Adnexa/parametrium involvement Diagnosed preoperativelyPreoperative whole pelvis radiotherapy followed by Total abdominal hysterectomy and B/L salpingoophorectomyDiagnosed postoperativelyTotal abdominal hysterectomy and B/L salpingoophorectomy + Adjuvant radiotherapy STAGE IVRadical surgery has little role.Main treatment is radiotherapy and chemotherapy.
Pelvic node involvement
Deep myometrial involvement
Enlarged uterine cavity
Poor differentiation
Carcinoma Endometrium