Isolated Vaginal Metastases of Endometrial Cancer and Their Role in Adjuvant Brachytherapy

Aim: This study aimed to investigate the effect of adjuvant vaginal brachytherapy (VBT) after initial surgery on local recurrence, disease-free survival, and overall survival (OS) in patients with endometrial cancer (EC). Methods: The data of patients diagnosed with EC at the gynecological oncology clinic between 1998 and 2021 were retrospectively analyzed. Patients who underwent total hysterectomy with negative surgical margins were included in the study. Results: Fifty-six patients who were treated for EC and subsequently developed isolated vaginal metastases (IVM) were evaluated. In the treatment of vaginal recurrence, 20 patients were treated with resection+VBT±external beam radiotherapy (EBRT)±chemotherapy and 36 patients were treated with VBT+EBRT±chemotherapy. The 5-year OS rates for patients who received resection+VBT treatment were 78.8% and 35.8% for patients who received EBRT+VBT treatment (p=0.023). The recurrence time did not significantly differ depending on whether or not adjuvant VBT was given (p=0.463). The mean 5-year OS rates were 49.4% and 62.5% in patients who did and did not receive VBT, respectively (p=0.521). As a result of the evaluation of risk factors that may affect OS in patients with IVM, according to Cox regression analysis, none of the prognostic factors were found to have a significant effect. Conclusion: This study found that adjuvant VBT did not affect local recurrence time and OS rate in patients with EC.