Table 1.

Comparison of Surgically and Clinically Staged Endometrial Cancer Trials

Trial	n	Stage	Surgery	Randomization	Vaginal and/or Pelvic Relapse	Overall Survival
GOG 99 (2004)18	392	IB, IC, occult II	TAH-BSO and lymphadenectomy	No additional therapy vs 50.4 Gy to pelvis	12% vs 3% at 2 years (P = .007)	86% vs 92% at 4 years (P = .557)
ASTEC (2009)28	906	IA, IB, IC, IIA	TAH-BSO ± lymphadenectomy	Brachytherapy vs vaginal brachytherapy + 40–46 Gy to pelvis	6.1% vs. 3.2% (P = .02)	84% vs 84% at 5 years (P = NS)
PORTEC (2004)30	714	IB grade 2/3, IC grade 1/2	TAH-BSO only	No additional therapy vs 46 Gy to pelvis	10%–14% vs 1%–5% at 5 years (P < .001)	70%–91% vs 58%–83% at 5 years (P = NS)
PORTEC 2 (2010)31	427	I or II, high-intermediate risk*	TAH-BSO, lymphadenectomy optional	46 Gy to pelvis vs vaginal brachytherapy	2.1% vs 5.1% at 5 years (P = .17)	79.6% vs 82.7% at 5 years (P = .57)

High-intermediate risk criteria: (1) age ≥ 60 and stage IC grade 1/2; (2) age ≥ 60 and stage IB grade 3; or (3) any age and stage IIA grade 1/2 or grade 3 with < 50% myometrial invasion.

ASTEC, Adjuvant External Beam Radiotherapy in the Treatment of Endometrial Cancer; GOG, Gynecologic Oncology Group; NS, not significant; PORTEC, Postoperative Radiation Therapy in Endometrial Carcinoma; TAH-BSO, total abdominal hysterectomy-bilateral salpingo-oophorectomy.

Adapted from Diavolitsis V et al.³²