Methods	Randomised controlled trial
Participants	92 FIGO stage I
Interventions	Melphalan chemotherapy versus treatment on progression
Outcomes	DFS and OS Adverse events in adjuvant chemotherapy arm: 79% had some degree of myelosuppression; 7 patients (16%) had severe myelosuppression; 5 patients (12%) had platelet count nadirs under 50,000 per cubic mm; 4 patients (9%) had platelet count nadirs under 2000 per cubic mm; no infectious complications related to leukopenia; no bleeding episodes related to thrombocytopenia induced by chemotherapy. 11 patients (26%) reported mild-to-moderate gastric gastrointestinal side effects. No other adverse effects were reported. One patient died 6 years after completing treatment, with a diagnosis of aplastic anaemia; no other myeloprolific disorders or second cancers were seen after > 250 person-years follow-up Adverse events in no adjuvant chemotherapy arm: not reported Median follow-up of surviving women: 6 years
Notes	Melphalan produced severe myelosuppression
Risk of bias
Bias	Authors’ judgement	Support for judgement
Random sequence generation (selection bias)	Low risk	Based on computer-generated random numbers
Allocation concealment (selection bias)	Low risk	Central randomisation by telephone call to co-ordinating centre
Incomplete outcome data (attrition bias) All outcomes	Low risk	Deemed ineligible after randomisation: T: 5/48 (10%) C: 6/44 (14%) Did not report whether any further loss to follow-up occurred
Blinding of outcome assessors (detection bias)	Unclear risk	Not reported
Selective reporting (reporting bias)	Unclear risk	ITT analysis; adverse events in ‘no adjuvant chemotherapy’ arm not reported

C = control; DFS = disease-free survival; ITT = intention-to-treat; OS = overall survival; T = treatment