Molecular classification of endometrial carcinoma across Canada: Variation in practice and opportunities to move towards consistency of care

Abstract

Objective: The Cancer Genome Atlas (TCGA)-inspired molecular classification of endometrial carcinoma enables consistent classification of tumors, provides prognostic and predictive information for patients and clinicians, identifies women who may have inherited cancer syndromes, and enables stratification of clinical trials to study treatment efficacy within biologically like tumors. Herein we characterize the molecular subtype distribution, management, and outcomes of recently diagnosed (2016) endometrial carcinomas managed across Canada and assess conventional management compared to how molecular classification may be implemented in direct care, reducing over-treatment in women whose endometrial carcinoma may be cured by surgery alone and avoiding under-treatment, with implications for both patient outcomes and health resources.