A 63-year-old woman undergoes surgical staging for endometrioid carcinoma and is found to have positive pelvic and para-aortic lymph nodes with peritoneal washings free of tumour. After optimal cytoreductive surgery, which systemic regimen is the established first-line adjuvant treatment?

• A Single-agent cisplatin
• B Carboplatin plus paclitaxel ✓
• C High-dose medroxyprogesterone alone
• D Methotrexate, actinomycin D, and cyclophosphamide

Explanation

Carboplatin plus paclitaxel is the standard first-line chemotherapy for advanced or metastatic endometrial carcinoma, having demonstrated comparable efficacy with better tolerability than doxorubicin-cisplatin regimens. Progestins are reserved for low-grade, hormone receptor positive recurrences, not node-positive high-volume disease. Single-agent cisplatin is inferior and more toxic, and the methotrexate-actinomycin-cyclophosphamide combination is the classic regimen for gestational trophoblastic disease, a common distractor across gynaecologic oncology.

Reference: Berek and Novak's Gynecology, 16th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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