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Perspective

A Modern Approach to Endometrial Carcinoma: Will Molecular Classification Improve Precision Medicine in the Future?

1
Department of Radiation Oncology, CyberKnife and Radiotherapy, Medical Faculty University Cologne, 50937 Cologne, Germany
2
Center of Integrated Oncology Cologne Bonn (CIO), 53127 Bonn, Germany
3
Institute of Pathology, Medical Faculty University Cologne, 50937 Cologne, Germany
4
Department of Women’s health, University Hospital Tuebingen, 72076 Tuebingen, Germany
*
Authors to whom correspondence should be addressed.
Cancers 2020, 12(9), 2577; https://doi.org/10.3390/cancers12092577
Received: 30 July 2020 / Revised: 22 August 2020 / Accepted: 30 August 2020 / Published: 10 September 2020
(This article belongs to the Special Issue Risk Factors for Endometrial Cancer)
The scientific community widely agrees that molecular classification will be key to endometrial carcinoma therapeutic strategies in the future. Retrospective analyses of large endometrial carcinoma patient cohorts gave rise to a new understanding of one of the most relevant gynecologic malignancies. Potentially replacing the current type I and type II terminology, four molecular subtypes have been established, each of them reflecting underlying molecular aberrations and distinct clinical behavior. Future research will have to focus on how to integrate these new findings into clinical practice with the ultimate goal to drive personalized endometrial carcinoma patient care forward.
Endometrial cancer has been histologically classified as either an estrogen-dependent cancer with a favorable outcome or an estrogen-independent cancer with a worse prognosis. These parameters, along with the clinical attributions, have been the basis for risk stratification. Recent molecular and histopathological findings have suggested a more complex approach to risk stratification. Findings from the Cancer Genome Atlas Research Network established four distinctive genomic groups: ultramutated, hypermutated, copy-number low and copy-number high prognostic subtypes. Subsequently, more molecular and histopathologic classifiers were evaluated for their prognostic and predictive value. The impact of molecular classification is evident and will be recognized by the upcoming WHO classification. Further research is needed to give rise to a new era of molecular-based endometrial carcinoma patient care. View Full-Text
Keywords: endometrial cancer; uterus carcinoma; molecular classification; risk classification; risk stratification; adjuvant radiation; brachytherapy; POLE; L1CAM; MMRd endometrial cancer; uterus carcinoma; molecular classification; risk classification; risk stratification; adjuvant radiation; brachytherapy; POLE; L1CAM; MMRd
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MDPI and ACS Style

Marnitz, S.; Walter, T.; Schömig-Markiefka, B.; Engler, T.; Kommoss, S.; Brucker, S.Y. A Modern Approach to Endometrial Carcinoma: Will Molecular Classification Improve Precision Medicine in the Future? Cancers 2020, 12, 2577. https://doi.org/10.3390/cancers12092577

AMA Style

Marnitz S, Walter T, Schömig-Markiefka B, Engler T, Kommoss S, Brucker SY. A Modern Approach to Endometrial Carcinoma: Will Molecular Classification Improve Precision Medicine in the Future? Cancers. 2020; 12(9):2577. https://doi.org/10.3390/cancers12092577

Chicago/Turabian Style

Marnitz, Simone, Till Walter, Birgid Schömig-Markiefka, Tobias Engler, Stefan Kommoss, and Sara Yvonne Brucker. 2020. "A Modern Approach to Endometrial Carcinoma: Will Molecular Classification Improve Precision Medicine in the Future?" Cancers 12, no. 9: 2577. https://doi.org/10.3390/cancers12092577

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