Defining risk groups: pathological prognostic features Defining risk groups: pathological prognostic features Defining risk groups: pathological prognostic features Defining risk groups: pathological prognostic features Management recommendations Management recommendations Management recommendations
Risk groups Tumour differentiation grade Histological type FIGO 2009 stage LVSI LND Adjuvant therapy Surgical method
Low risk
G1 / G2
Endometrioid
IA
Negative
No
No
Minimally invasive approach preferable
Intermediate risk
G1 / G2
IA
Positive
Prognostic benefit: can be considered for staging purposes [Therapeutic benefit: uncertain]
No recommendations
G1 / G2 IB Negative Adjuvant brachytherapy / no adjuvant treatment for <60 years old
G3
IA
Negative
If node negative confirmed by surgical staging: same as above If no surgical nodal staging: adjuvant brachytherapy alone
High-intermediate risk G3 IA Positive No surgical nodal staging: adjuvant EBRT
G1 / G2 IB Positive No recommendations
High risk
G3
IB
Negative / positive
Prognostic benefit: Yes [Therapeutic benefit: uncertain] If node negative confirmed by surgical staging: adjuvant EBRT with limited fields / adjuvant brachytherapy If no surgical nodal staging: EBRT and chemotherapy in combination is preferred over giving either treatment alone
G3 Non-endometrioid IA / IB Negative / positive See advanced endometrial cancer section
G1 / G2 / G3 Uncertain II Negative / positive