The PORTEC-3 trial (2018) compared concurrent chemoradiotherapy (CCRT) versus pelvic radiotherapy alone in high-risk endometrial cancer. For which specific FIGO Stage subgroup did CCRT show a significant improvement in overall survival compared to radiotherapy alone?

• A Stage III endometrial cancer and Stage II/III serous or clear cell histology ✓
• B Stage IA Grade 3 endometrioid carcinoma
• C Stage IB Grade 2 with lymphovascular space invasion
• D All high-risk endometrial cancers regardless of stage

Explanation

The PORTEC-3 trial randomised 686 patients with high-risk endometrial cancer to CCRT versus pelvic EBRT alone. At 5-year follow-up, CCRT improved failure-free survival overall, but the overall survival benefit was specifically seen in the subgroup with Stage III disease and in women with serous histology (Stage II/III). Stage IA Grade 3 and Stage IB did not significantly benefit from the addition of chemotherapy. This has shaped current guidelines — CCRT is now recommended for Stage III endometrial cancer and for serous/clear cell histology Stage II–III, while intermediate-risk stage I–II endometrioid may receive RT alone.

Reference: Shaw's Textbook of Gynaecology, 17th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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