A 58-year-old woman undergoes total hysterectomy and bilateral salpingo-oophorectomy for Stage IB Grade 1 endometrioid endometrial carcinoma. There is no lymphovascular space invasion and lymph nodes are negative. What is the most appropriate adjuvant therapy to reduce vaginal vault recurrence?
- A Pelvic external beam radiotherapy
- B Combined chemoradiation
- C Vaginal brachytherapy ✓
- D Observation only
Correct answer: C. Vaginal brachytherapy
Explanation
For intermediate-risk endometrial cancer (Stage IB, Grade 1-2, no LVSI), vaginal brachytherapy is the standard adjuvant treatment. It effectively reduces vaginal vault recurrence with fewer side effects compared to pelvic external beam radiotherapy, as demonstrated in the PORTEC-2 trial.
Reference: Bailey and Love's Short Practice of Surgery, 28th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.