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Review
. 2021 May 26;13(11):2623.
doi: 10.3390/cancers13112623.

New Pathological and Clinical Insights in Endometrial Cancer in View of the Updated ESGO/ESTRO/ESP Guidelines

Angela Santoro  1 , Giuseppe Angelico  1 , Antonio Travaglino  1 , Frediano Inzani  1 , Damiano Arciuolo  1 , Michele Valente  1 , Nicoletta D'Alessandris  1 , Giulia Scaglione  1 , Vincenzo Fiorentino  1 , Antonio Raffone  2 , Gian Franco Zannoni  1   3
Affiliations
Review

New Pathological and Clinical Insights in Endometrial Cancer in View of the Updated ESGO/ESTRO/ESP Guidelines

Angela Santoro et al. Cancers (Basel). .

Abstract

Endometrial carcinoma represents the most common gynecological cancer in Europe and the USA. Histopathological classification based on tumor morphology and tumor grade has played a crucial role in the management of endometrial carcinoma, allowing a prognostic stratification into distinct risk categories, and guiding surgical and adjuvant therapy. In 2013, The Cancer Genome Atlas (TCGA) Research Network reported a large scale molecular analysis of 373 endometrial carcinomas which demonstrated four categories with distinct clinical, pathologic, and molecular features: POLE/ultramutated (7% of cases) microsatellite instability (MSI)/hypermutated (28%), copy-number low/endometrioid (39%), and copy-number high/serous-like (26%). In the present article, we report a detailed histological and molecular review of all endometrial carcinoma histotypes in light of the current ESGO/ESTRO/ESP guidelines. In particular, we focus on the distribution and prognostic value of the TCGA groups in each histotype.

Keywords: CTNNB1; TCGA; clear cell carcinoma; endometrial carcinoma; prognosis; serous carcinoma; undifferentiated carcinoma.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Distribution of TCGA molecular groups according to endometrial carcinoma histotype.
Figure 2
Figure 2
Molecular landscape of endometrial carcinoma: the role of the immunohistochemical surrogates. (A,B) Dedifferentiated carcinoma with mismatch repair deficiency. (C,D) Serous carcinoma with abnormal p53 expression. (E,F) Endometrioid carcinoma with nuclear beta-catenin accumulation. (G,H) Endometrioid carcinoma with positivity for L1CAM in >10% of tumor cells (H&E, LSAB, 10×).
See this image and copyright information in PMC

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