A 62-year-old post-menopausal woman with stage IA endometrioid endometrial carcinoma (Grade 1, invasion <50% myometrium, no LVSI) undergoes total hysterectomy and bilateral salpingo-oophorectomy. According to ESMO-ESGO-ESTRO 2021 risk classification, she is in which risk group and what adjuvant treatment is recommended?
- A Low-intermediate risk — vaginal brachytherapy
- B High-intermediate risk — external beam radiotherapy (EBRT)
- C Low risk — no adjuvant treatment required ✓
- D High risk — concurrent chemoradiation
Correct answer: C. Low risk — no adjuvant treatment required
Explanation
ESMO-ESGO-ESTRO 2021 classifies Stage IA, Grade 1–2 endometrioid carcinoma with no LVSI as LOW RISK — these patients have excellent prognosis and no adjuvant therapy is recommended after complete surgical staging. Low-intermediate risk includes Stage IA Grade 3, IB Grade 1–2 without LVSI, or Stage IA Grade 1–2 with LVSI, where vaginal brachytherapy may be considered. EBRT and chemotherapy are reserved for high-risk and advanced-stage disease.
Reference: Shaw's Textbook of Gynaecology, 17th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.