3 The significant prognostic differences across the four subgroups were demonstrated in a retrospective analysis of the Post- Operative Radiation Therapy in Endometrial Carcinoma (PORTEC)-3 trial assessing the benefit of combined adjuvant chemotherapy and radiotherapy versus radiotherapy alone in women with high-risk endometrial cancer. LVSI, lymph-vascular space invasion MSI, microsatellite instable MSS, microsatellite stable neg, negative NSMP, non-specific molecular profile pos, positive POLƐ, polymerase epsilon.Īccording to The Cancer Genome Atlas, four molecular classes with different prognoses are currently identified. New risk stratification of endometrial cancer 2021.** Advanced stage: FIGO III with residual disease or FIGO IVA metastatic disease: FIGO IVB FIGO non-endometrioid: serous, clear cell, undifferentiated. On the other hand, tumors with a p53 dysfunction have a poor prognosis as a result of genomic instability and rapid progression. 4 Those patients are likely over-treated by standard therapies since it is not fully clear whether this good prognosis is due to excellent treatment response or whether the course of the disease would be similar without treatment. The primary goal of treating physicians is to improve the prognosis of patients and to apply personalized treatments.ĭe-escalating strategies are warranted where the prognosis is superior, e.g., in patients with polymerase epsilon (POLƐ)-mutated disease ( Table 1). 3 Molecular features in endometrial cancer have been acknowledged, which help to refine prognostic information. Published in 2013, The Cancer Genome Atlas classification system was a breakthrough in the understanding of this disease. 2 This evolved to be insufficient to accurately estimate the risk of relapse in patients with endometrial cancer. Until recently, endometrial cancer was defined by histology as either type I (endometrioid histology, obesity, hormone-receptor-positivity usually good prognosis) or type II (mainly serous histology bad prognosis) disease. Molecular subtypes defining risk of relapse
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