Thus, the ESGO/ESTRO/ESP consensus in 2020 defined for the first time different prognostic risk groups integrating molecular markers. The incorporation of such molecular alterations into established clinicopathologic risk factors resulted in a refined, improved risk assessment.

The validation of surrogate markers (p53, Mismatch repair deficiency, and POLE) to determine these subgroups and the addition of other molecular prognosticators (CTNNB1, L1CAM) resulted in a practical and clinically useful molecular classification tool. Integrated genomic characterization by the Cancer Genome Atlas (TCGA) in 2013 defined four distinct endometrial cancer subgroups (POLE mutated, microsatellite instability, low copy number, and high copy number) with possible prognostic value. Despite the excellent prognosis for early stages, considerable under- and overtreatment remains.

2Dipartimento di Scienze della vita e sanitГ pubblica, UniversitГ Cattolica del Sacro Cuore, Rome, ItalyДЄdjuvant therapy recommendations for endometrial cancer were historically based on the individual patientвЂ™s risk of disease recurrence using clinicopathologic factors such as age, stage, histologic subtype, tumor grade, and lymphovascular space invasion.1Direzione Scientifica, Fondazione Policlinico Universitario A.Camilla Nero 1,2*, Francesca Ciccarone 1, Antonella Pietragalla 1, Simona Duranti 1, Gennaro Daniele 1, Giovanni Scambia 1,2 and Domenica Lorusso 1,2

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