Table 1.

Risk groups of endometrial cancer and current treatment recommendations

Risk group	ESMO-ESGO-ESTRO consensus1	Common treatment recommendations
Low risk	Stage I EEC, grade 1–2,<50% myometrial invasion, LVSI negative	No adjuvant treatment
Low-intermediate risk	Stage I EEC, grade 1–2,≥50% myometrial invasion, LVSI negative	Vaginal brachytherapy (consider observation if age <60 years)
High-intermediate risk	Stage I EEC, grade 3, <50% myometrial invasion, any LVSI Stage I EEC, grade 1–2, LVSI unequivocally positive, any myometrial invasion	Vaginal brachytherapy Consider pelvic external beam radiotherapy if LVSI is unequivocally positive, especially if no lymph node dissection or sentinel node has been performed.
High risk	Stage I EEC, grade 3, ≥50% myometrial invasion, any LVSI	External beam radiotherapy Consider vaginal brachytherapy if no LVSI
	Stage II EEC Stage III EEC	Vaginal brachytherapy if grade 1–2 and LVSI negative Pelvic radiotherapy if : Stage II, grade 3 LVSI unequivocally positive Stage III Stage III: combined adjuvant radiotherapy and chemotherapy (PORTEC-3 schedule or sequential)
	NEEC stage I–III (serous, clear cell or undifferentiated cancers; carcinosarcoma)	Vaginal brachytherapy if serous/clear cell, stage IA after full surgical staging, LVSI negative Stage IB–III: combined adjuvant pelvic radiotherapy and chemotherapy

EEC, endometrioid endometrial cancer; ESGO, European Society of Gynecological Oncology; ESMO, European Society for Medical Oncology; ESTRO, European Society; LVSI, lymph-vascular space invasion; NEEC, non-endometrioid endometrial cancer; PORTEC, post operative radiation therapy endometrial cancer.