For gross disease
, 55 Gy or more should be considered.
The challenge has been that although 55-60 Gy is needed to effectively treat postsurgical residual gross disease, the safe limit of exposure is lower (for example, just 45 Gy to the spinal cord).
He reported on a series of 20 patients who underwent IMRT for high-risk thyroid cancer due to residual microscopic disease in the tracheal/esophageal groove postsurgically, or gross disease after radioactive iodine.
1) The role of the general gynecologist in surgical management of these cases is controversial; at some institutions, the practice is to call in the gynecologic oncologist for lymph-node sampling or when gross disease
is identified; at others, the standard is to refer the patient to gynecologic oncology as soon as malignancy is diagnosed by endometrial biopsy.
In a case like this, where extension of disease was great, the morbidity of surgery was weighed against its benefit and the decision was made to remove all gross disease
surgically, followed by adjuvant radiation therapy.
My suspicion is that these patients had gross disease
Staging includes hysterectomy, bilateral salpingo-oopborectomy, and biopsy of any gross disease
All gross disease
was removed in all surgically treated patients.
9-11) GOG 184 inclusion criteria required surgical resection of gross disease
to [less than or equal to] 2 cm in diameter.
Patients who had microscopic disease experienced better local control than those with gross disease