This definition appears rarely
Most compelling is the fact that vaginal recurrences usually can be prevented with a modest dose of superficial vaginal brachytherapy. It is difficult to imagine an anatomic explanation for a pattern of tumor spread from the uterine fundus that involves lymphatic vessels of the vagina but not those of other paracervical tissues. Although vaginal metastases are occasionally present at the time of initial diagnosis, this situation is very rare, occurring in less than 1% of patients with newly diagnosed endometrial cancer. Another argument against the theory of lymphovascular spread as a mechanism for vaginal recurrence is the fact that vaginal recurrences are seen with some frequency in patients with minimally invasive, even noninvasive, cancers, particularly high-grade cancers. In the Postoperative Radiation Therapy in Endometrial Carcinoma.