What are the recommended follow-up and management strategies for a female patient with a history of recurrent endometrial cancer, specifically Stage II Endometrioid Adenocarcinoma, G2, with recurrence involving the vaginal cuff, who has undergone external beam radiation therapy (EBRT) and high-dose rate (HDR) brachytherapy?

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Last updated: November 18, 2025View editorial policy

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History of Present Illness

Ms. Champion is a female with Stage II (FIGO 2010) Grade 2 endometrioid adenocarcinoma of the endometrium, initially diagnosed in October 2020, who developed vaginal cuff recurrence in November 2022 without metastatic disease. She completed definitive salvage radiation therapy from February 2023 to April 2023, consisting of external beam radiation therapy (5000 cGy in 25 fractions) followed by 4 fractions of high-dose rate brachytherapy for a total dose of 7297 cGy to the vaginal surface. 1

She presents for scheduled surveillance follow-up and reports no major medical changes since her last visit. Her most recent pelvic examination by gynecologic oncology in April 2025 demonstrated no evidence of disease. PET-CT imaging performed in June 2025 confirmed no evidence of recurrent or metastatic disease. 1, 2

Current Disease Status

  • Primary diagnosis: Stage II endometrioid adenocarcinoma, Grade 2 (October 2020)
  • Recurrence: Vaginal cuff involvement (November 2022), no distant metastases
  • Treatment completed: Salvage radiation therapy (February-April 2023) with curative intent 1
  • Current status: No evidence of disease by clinical examination (April 2025) and imaging (June 2025) 2
  • Time from completion of salvage therapy: Approximately 24 months disease-free

Surveillance Context

The patient is within the critical 3-year post-treatment window when 68-100% of endometrial cancer recurrences typically occur, warranting continued close surveillance with clinical examinations every 3-4 months. 1, 2, 3 Her excellent response to salvage radiation therapy for isolated vaginal recurrence is consistent with reported complete remission rates of 89% and 5-year survival rates of 50-70% for this clinical scenario. 1, 4

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Guideline

Vaginal Cuff Pap Smear Screening After Endometrial Cancer Treatment

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2025

Research

Outcome after salvage radiotherapy (brachytherapy +/- external) in patients with a vaginal recurrence from endometrial carcinomas.

Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology, 2002

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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