Abstract
Endometrial cancer is the most common gynecological malignancy of the female reproductive organs. Historically it was divided into type I and type II, until 2013 when the Cancer Genome Atlas molecular classification was proposed. Here, we applied the different classification types on our endometrial cancer patient cohort in order to identify the most predictive one. We enrolled 117 endometrial cancer patients available for the study and collected the following parameters: age, body mass index, stage, menopause, Lynch syndrome status, parity, hypertension, type of localization of the lesion at hysteroscopy, type of surgery and complications, and presence of metachronous or synchronous tumors. The tumors were classified according to the European Society for Medical Oncology, Proactive Molecular Risk Classifier for Endometrial Cancer, Post-Operative Radiation Therapy in Endometrial Carcinoma, and Cancer Genome Atlas classification schemes. Our data confirmed that European Society for Medical Oncology risk was the strongest predictor of prognosis in our cohort. The parameters correlated with poor prognosis were the histotype, FIGO stage, and grade. Our study cohort shows that risk stratification should be based on the integration of histologic, clinical, and molecular parameters.
Highlights
Endometrial cancer (EC) is the most common gynecological neoplasm and has traditionally been classified into type I estrogen-related tumors and type II non-estrogen-related cancers
Surgical staging was performed according to ESGO-European Society for Medical Oncology (ESMO) guidelines and included hysterectomy and bilateral salpingo-ovariectomy (BSO), with lymphadenectomy in high-grade cases and myometrial invasion greater than 50% at intraoperative frozen section (FS) examination
The same group of qualified gynecological pathologists carried out all histological analyses
Summary
Endometrial cancer (EC) is the most common gynecological neoplasm and has traditionally been classified into type I estrogen-related tumors (about 80% of cases) and type II non-estrogen-related cancers. This dualism represents two different types of cancer, according to etiology, histology, and prognosis. Intraepithelial Carcinoma (EIC) in a context of endometrial atrophy, estrogen unrelated. This tumor is represented by serous, clear cell histotypes or carcinosarcomas with poor prognosis. This classification was used until 2013, when the molecular classification was applied [4]
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