Table 1.
Risk groups in endometrial cancer as proposed by the ESMO-ESGO-ESTRO consensus guideline and related adjuvant treatment [3]
| Risk group | Description | Current adjuvant treatments |
|---|---|---|
| Low | FIGO stage IA EEC: grade 1–2, LVSI neg. | NAT |
| Intermediate | FIGO stage IB EEC: grade 1–2, LVSI neg. | VBT (NAT if age < 60) |
| High-intermediate | FIGO stage IA/B EEC: grade 1–2, LVSI pos. | VBT (EBRT if stage IB LVSI pos.) |
| FIGO stage IA EEC: grade 3, LVSI neg. | VBT (NAT if age < 60) | |
| FIGO stage IA EEC: grade 3, LVSI pos. | EBRT (VBT if LNI neg.) | |
| High | FIGO stage IB EEC: grade 3 | EBRT (VBT if LVSI neg. or LNI neg.) |
| FIGO stage II EEC: grade 1–2, LVSI neg. | VBT | |
| FIGO stage II EEC: grade 1–2, LVSI pos. | EBRT +/− VBT boost | |
| FIGO stage II EEC: grade 3 or LVSI pos. | EBRT | |
| FIGO stage III EEC | EBRT + CT* | |
| FIGO stage IA SC/CC, LVSI neg. | VBT | |
| FIGO stage > IB SC/CC | EBRT + CT |
FIGO, International Federation of Gynecology and Obstetrics 2009; EEC, endometrioid endometrial cancer; LVSI, lymph-vascular space invasion (neg.: negative, pos.: substantial LVSI); NAT, no adjuvant treatment; VBT, vaginal brachytherapy; LNI, lymph node involvement (surgical staged); EBRT, external beam radiotherapy; CT, chemotherapy; SC, serous carcinoma; CC, clear cell carcinoma
Italic: to be considered
*EBRT and chemotherapy either combined (PORTEC-3 and GOG 258 schedule) or sequentially