New approaches to staging and treatment of primary endometrial cancer

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Abstract

In 1972 Ya.V. Bokhman identified and substantiated the existence of two types of endometrial cancer (EC), which differ in pathogenesis, tumor histological type, clinical course and prognosis. Various molecular changes characteristic of each type were later discovered. In recent years, four molecular subgroups of EC have been identified and characterized: with ultramutated POLE (POLE mut4); with hypermutated microsatellite instability (MSI); with low copy number and low mutational load, and subgroup with high copy number and frequent TP53 mutations. Several large randomized studies have confirmed the prognostic significance of these molecular subgroups. The research results influenced the creation of a new WHO histological classification in 2020 and a new FIGO classification for staging EC in 2023. The review provides molecular classification of EC, new FIGO 2023 classification, new classification of risk groups for EC, ESGO/ESTRO/ESP ESGO/ ESTRO/ESP 2021 recommendations on the diagnosis and treatment of EC. The use of these new classifications and recommendations in oncological practice will provide personalizing the treatment of patients with EC.

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About the authors

Elena V. Bakhidze

Petrov National Medical Research Center of Oncology

Author for correspondence.
Email: bakhidze@yandex.ru
ORCID iD: 0000-0003-0317-8050
SPIN-code: 5191-8792

Dr. Sci. (Med.); Leading Researcher at the Department of Oncogynecology

Russian Federation, St. Petersburg

A. V. Belyaeva

North-Western State Medical University n.a. I.I. Mechnikov

Email: bakhidze@yandex.ru
ORCID iD: 0000-0002-6299-2856
Russian Federation, St. Petersburg

I. V. Berlev

Petrov National Medical Research Center of Oncology; North-Western State Medical University n.a. I.I. Mechnikov

Email: bakhidze@yandex.ru
ORCID iD: 0000-0001-6937-2740
Russian Federation, St. Petersburg; St. Petersburg

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