Residual carcinoma after intracavitary irradiation of endometrial carcinoma, stage I. A study of whole-organ sections.

Surgical specimens from 87 patients with endometrial carcinoma, stage I, preoperatively treated by intracavitary irradiation were investigated by a whole-organ sectioning technique. Re-examination of the curettage material showed cancer stage 0 in 8 (9%) and carcinoma state I in 79 cases (91%). In the stage I cases 57% showed residual carcinoma localized mainly to the myometrium of the uterine body and cornuae. Histological changes inthe carcinoma were unevenly distributed, but tumors growing close to the external uterine surface were well preserved. In 40.5%, no carcinoma was present, and in 2.5% the changes found could not be classified. Correlated to disparity in irradiation technique, no significant difference could be demonstrated in the incidence or localization of residual carcinoma. The most important single pretreatment factor combined with the presence of residual carcinoma was myometrial fragments with infiltrating carcinoma in the curettage material (MICC). Computerized analysis of combinations of factors showed that all patients aged over 60 years with a uterine-sound length exceeding 8 cm had residual carcinoma. Only 2 patients with infiltration of the myometrium had a completely destroyed carcinoma. The findings indicate that it is unlikely that endometrial carcinoma state I with myometrial invasion will be eradicated by intracavitary irradiation.