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 |
|
|
|