Gynae oncologyFree in the app
Endometrial cancer — treatment
Surgery plus molecular class guides everything.
Source: FIGO 2023 · ESGO/ESTRO/ESP 2025Surgery
- Total hysterectomy and BSO, laparoscopic where possible.
- Sentinel node mapping for stage I–II.
- Omentectomy for serous, undifferentiated or carcinosarcoma.
Molecular classes
| POLE-mutated | Excellent prognosis — stage I–II needs no adjuvant treatment. |
|---|---|
| MMR-deficient | Intermediate risk; test for Lynch syndrome. |
| p53-abnormal | High risk — multimodal adjuvant treatment. |
| No specific profile (NSMP) | Split by oestrogen receptor status. |
- Universal MMR testing at diagnosis; MLH1 loss → methylation test → genetics if unmethylated.
- Advanced or recurrent: carboplatin-paclitaxel plus immunotherapy (dostarlimab, pembrolizumab or durvalumab), biggest benefit if MMR-deficient.
- Fertility-sparing: grade 1 endometrioid confined to endometrium — progestogen or LNG-IUS after hysteroscopic resection.
A summary for trained clinicians. Always check the full guideline, the patient in front of you and your hospital's protocol. Spotted an error? Tell us.