Early-Stage Endometrial Cancer: Is Adjuvant Radiation Really Warranted?

Endometrial cancer is the most common gynecologic malignancy in the United States. The vast majority of these cases are discovered when the disease is still limited to the uterus. There is a consensus agreement that the initial treatment and management should be surgical staging; however, there remains much controversy as to the use and role of adjuvant radiation in the setting of early-stage endometrial cancer. In the literature to date, there has not been resounding evidence to support the use of adjuvant radiation therapy in this early disease state. This is somewhat troublesome because this is the most common disease state of the most common gynecologic malignancy; finding the optimal treatment would be of massive benefit to patients and physicians as well as to society as a whole. Herein, the relevant literature is reviewed to demonstrate that the use of adjuvant radiation therapy is not clearly supported in the setting of early-stage endometrial cancer.