Stage 2 endometrioid, "suspicious" for LVSI

I have regular endometrial adenocarcinoma. I also was suspicious for lymph vascular invasion though further testing (staining) didn't support that. The surgeon said I would be treated as if I did have LVI to be on the safe side. I was 3a as I had a few cells on my left ovary, pelvic wash and lymph nodes were clear. I don't have my pathology report handy but I think myometrial invasion was about 75%. 

It was decided that I would receive 6 doses of carbo/taxol chemo and then 5 weeks (25 times) of targeted beam radiation. No bracytheraphy. As I  turned out to be allergic to Taxol I'm receiving 8 doses of adriamyacin and carbo. I finish in April with chemo then onto the radiation. I am anemic from the adriamyacin but otherwise ok. 

I had my operation in early October and the two subsequent CT scans have been clear. 

Chemo targets the risk of systemic/distant metastases, which pelvic radiation can't target. I guess it comes down to determining when that risk is high enough to risk the side effects of chemotherapy.

I think part if the problem is that studies have not yet provided black and white guidance. For example, my rad onc did go ahead and recommend radiation, but he also made clear that studies have not proven that adjunctive radiation (given up front to prevent recurrence) prolongs life. With that kind of ambiguity, different doctor's are going to judge the risks and benefits differently.

Tamlen said:

What good news that your

What good news that your scans have been clear after everything you've been through.

I haven't yet had the chance to ask my gyn/onc why radiation instead of chemo/radiation, so I am puzzling over why some on this forum have had that protocol (chemo + radiation). Are you able to say why they recommended chemo in addition to radiation?

And which kind of targeted beam radiation did you have -- IMRT?

Thanks so much for replying to my questions.

My oncologists are following the NCCN guidelines for endometrial cancer. For stage 3a adjuvant treatment is systemic therapy and or external beam radiation, and possibly brachytherapy. My surgeon explained that at surgery she thought I was Ib as she didn't see the couple of cells on my ovary.  But with that and inconclusive findings on LVI, the doctors felt systemic therapy (chemo) and targeted radiation where the way to go. As my tumor was in the upper uterine segment they thought brachytherapy  was not needed. So you might ask your doctor what the NCCN guidelines say for your particular stage.

I haven't had radiation yet, but it will be IMRT.

Hello,

I am somewhat similar to you.  I was diagosed 1/2017 with stage 2 grade 2 EC.  I had 60 percent wall invasion, and also had a foci suspicious for LVSI.  I ended up getting 4 path reports over that foci suspicious for LVSI, and the only one that thought this was the original patholologist. When you have robotic surgery sometimes the balloon that they use can cause fragments of tumor to move.  There is quite a bit of research on this and the jury is still out.  I have done so much research on this because I was completely concerned over it.  So I could go on and on about it, but generally what is more concerning is extensive or even unequivocal focal LVSI, rather than a single focus, which was what mine was said to be. I was treated with the plan that they are suggesting for you.  However, I ventured out on my own and found some research and convinced them to give me 4 cycles of carbo/taxol after completing radiation. Since this time the PORTEC 3 trial really did not find evidence of value in adding chemotherapy to stage 2 ECs, however, they do not have any sub group analysis yet so you never know.  I don't regret it, and I am almost 15 months NED.  I am in and out of this forum, should come on more, so feel free to email me if you would like to:  patrkuenzi@gmail.com. I am a medical professional and have spent the past 15 months making EC my primary focus, so I may be able to help you with more questions.  Along with my own personal experience of course.

Hi, not sure what you mean about the radiation?   For stage 2 it is the first recommended treatment.  What stage were you?  Hope all is well:)

You are correct.  It is recommended treatment for stage 2 EC grade 1-2.  Chemo is not usually given to Stage 2 EC low grade, only with high risk (LVSI, outer third myometrial invasion, over 60 yo).