Bruno Valentina, Logoteta Alessandra, Chiofalo Benito, Mancini Emanuela, Betti Martina, Fabrizi Luana, Piccione Emilio, Vizza Enrico
Gynecologic Oncology Unit, Department of Experimental Clinical Oncology, IRCCS "Regina Elena" National Cancer Institute, Via Elio Chianesi 53, 00144, Rome, Italy.
Department of Maternal and Child Health and Urological Sciences, University of Rome "Sapienza", Policlinico "Umberto I", Rome, Italy.
Arch Gynecol Obstet. 2024 Mar;309(3):745-753. doi: 10.1007/s00404-023-07128-z. Epub 2023 Jul 6.
A huge effort has been done in redefining endometrial cancer (EC) risk classes in the last decade. However, known prognostic factors (FIGO staging and grading, biomolecular classification and ESMO-ESGO-ESTRO risk classes stratification) are not able to predict outcomes and especially recurrences. Biomolecular classification has helped in re-classifying patients for a more appropriate adjuvant treatment and clinical studies suggest that currently used molecular classification improves the risk assessment of women with EC, however, it does not clearly explain differences in recurrence profiles. Furthermore, a lack of evidence appears in EC guidelines. Here, we summarize the main concepts why molecular classification is not enough in the management of endometrial cancer, by highlighting some promising innovative examples in scientific literature studies with a clinical potential significant impact.
在过去十年中，人们在重新定义子宫内膜癌（EC）风险类别方面付出了巨大努力。然而，已知的预后因素（国际妇产科联盟（FIGO）分期和分级、生物分子分类以及欧洲肿瘤内科学会（ESMO）-欧洲妇科肿瘤学会（ESGO）-欧洲放射肿瘤学会（ESTRO）风险类别分层）无法预测结局，尤其是复发情况。生物分子分类有助于对患者进行重新分类，以便进行更合适的辅助治疗，临床研究表明，目前使用的分子分类改善了子宫内膜癌女性的风险评估，然而，它并未清楚地解释复发情况的差异。此外，子宫内膜癌指南中也缺乏证据。在此，我们通过强调科学文献研究中一些具有临床潜在重大影响的有前景的创新实例，总结了分子分类在子宫内膜癌管理中为何不足的主要概念。
