The PORTEC-3 trial evaluated the role of adjuvant chemotherapy in high-risk endometrial carcinoma. Its key finding was:

• A Combined chemoradiation improved failure-free survival compared to pelvic radiation alone in high-risk endometrial carcinoma ✓
• B Pelvic radiation alone was superior to chemoradiation for high-risk endometrial cancer
• C Vaginal brachytherapy alone was adequate for stage III endometrial carcinoma
• D Chemotherapy alone was superior to radiation for distant metastasis prevention

Explanation

PORTEC-3 randomized high-risk endometrial carcinoma patients (stage I–II with high-risk features, stage III, or serous/clear cell histology) to concurrent chemoradiation versus pelvic radiation alone. Chemoradiation (cisplatin concurrently with radiation followed by carboplatin-paclitaxel) significantly improved 5-year failure-free survival and overall survival in stage III and high-risk patients. This trial established concurrent chemoradiation as standard for high-risk/advanced endometrial cancer. Stage III disease showed greatest benefit.

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

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