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Cancers
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Survivorship and Quality of Life in Endometrial Cancer
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Survivorship and Quality of Life in Endometrial Cancer

A special issue of Cancers (ISSN 2072-6694). This special issue belongs to the section "Cancer Survivorship and Quality of Life".

Deadline for manuscript submissions: closed (31 May 2026) | Viewed by 3896

Special Issue Editors

Dr. George Koukourakis

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Guest Editor
Consultant Clinical Oncologist, St Savvas Oncology Hospital, Athens, Greece
Interests: gynaecological oncology; endometrial and cervical cancer
Dr. Antonios Anagnostopoulos

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Guest Editor
Agios Savvas Cancer Hospital, Athens, Greece
Interests: minimal access surgery; surgical radicality and morbidity; follow-up strategies
Special Issues, Collections and Topics in MDPI journals
Dr. Georgios Angelopoulos

E-Mail Website
Guest Editor
Consultant Gynaecological Oncology Surgeon, Lancashire Teaching Hospital, Preston, UK
Interests: gynaecological cancers (endometrial, cervical, ovarian, vulvo-vaginal, minimal access surgery (robotic and laparoscopic), radical and exenterative surgery)
Dr. Anthi Miliadou

E-Mail
Guest Editor
Consultant Clinical Oncologist, St Savvas Oncology Hospital, Athens, Greece
Interests: endometrium-cervix and vulva cancer

Special Issue Information

Dear Colleagues,

Endometrial cancer (EC) incidence is rapidly rising, especially in high- and middle-income countries. Over 400,000 cases were diagnosed globally in 2022, ranking EC at 15th amongst all cancers. At the same time, more than 300,000 patients are surviving EC annually, since mortality has steadily been decreasing for decades where access to healthcare is available. A substantial amount of new evidence is gradually altering the landscape in the management of EC. The addition of novel systemic treatments have recently proven their survival benefit in specific subtypes of advanced and recurrent disease, where prognosis used to be dismal. While the efficacy of multiple modes of cancer treatments is the main focus of research, the overall and mainly long-term impact of these treatments in patients’ quality of life is usually neglected. With an expected increasing number of EC survivors and available combinations of treatment options, research should focus on producing evidence which promotes patient quality of life.

In this Special Issue, we invite research articles and reviews on the essential elements required to promote quality of life throughout the EC patients’ journey.

Dr. George Koukourakis
Dr. Antonios Anagnostopoulos
Dr. Georgios Angelopoulos
Dr. Anthi Miliadou
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as communications are invited. For planned papers, a title and short abstract (about 250 words) can be sent to the Editorial Office for assessment.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Cancers is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2900 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • endometrial cancer
  • quality of life
  • survivorship

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Published Papers (4 papers)

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Research

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17 pages, 3667 KB  
Article
Prognostic Value of p53 Status in Endometrial Cancer: Real-World Evidence from a Tertiary Center
by Prapaporn Suprasert, Tanadon Salakphet, Tip Pongsuvareeyakul and Surapan Khunamornpong
Cancers 2026, 18(11), 1805; https://doi.org/10.3390/cancers18111805 - 1 Jun 2026
Viewed by 104
Abstract
Background: p53 immunohistochemistry is widely used as a surrogate marker for molecular classification in endometrial cancer and is generally associated with aggressive tumor behavior. However, its independent prognostic value in real-world clinical settings remains uncertain. Methods: This retrospective cohort study included [...] Read more.
Background: p53 immunohistochemistry is widely used as a surrogate marker for molecular classification in endometrial cancer and is generally associated with aggressive tumor behavior. However, its independent prognostic value in real-world clinical settings remains uncertain. Methods: This retrospective cohort study included patients with histologically confirmed endometrial cancer treated at a tertiary center between 2015 and 2023. Patients with available p53 immunohistochemical results were classified as p53 wild-type or p53-abnormal status. Clinicopathologic characteristics were compared between groups. Survival outcomes, including overall survival (OS) and progression-free survival (PFS), were analyzed using the Kaplan–Meier method and compared with the log-rank test. Cox proportional hazards models were used to identify independent prognostic factors. Sensitivity analyses were performed to assess the impact of treatment-related variables. Results: A total of 132 patients were included. p53-abnormal tumors were associated with older age, high-grade non-endometrioid histology, and more frequent use of adjuvant therapy. In Kaplan–Meier analysis, p53-abnormal status was associated with poorer OS (5-year OS: 54.8% vs. 77.1%, p = 0.029), with a similar trend observed for PFS. However, in multivariable analysis, p53 status was not independently associated with survival. Instead, advanced stage and residual disease remained significant prognostic factors. Sensitivity analyses incorporating treatment-related variables yielded consistent results, confirming the lack of independent prognostic impact of p53. Conclusions: Although p53-abnormal status was associated with adverse clinicopathologic features and worse unadjusted survival, it was not an independent prognostic factor after adjustment. These findings suggest that the prognostic impact of p53 is context-dependent and largely mediated by established clinical factors, particularly tumor burden. Integrated clinicopathologic and molecular assessment remains essential for accurate risk stratification in endometrial cancer. Full article
(This article belongs to the Special Issue Survivorship and Quality of Life in Endometrial Cancer)
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16 pages, 2456 KB  
Article
Comparative Prognostic Evaluation of the Revised International Federation of Gynecology and Obstetrics 2023 and 2009 Staging Systems in Early Endometrial Cancer
by Su Lim Lee, Yu Ri Shin, Hokun Kim and Sung Eun Rha
Cancers 2025, 17(18), 3017; https://doi.org/10.3390/cancers17183017 - 16 Sep 2025
Cited by 1 | Viewed by 1289
Abstract
Background/Objectives: We comparatively evaluated the prognostic performance of the 2009 and 2023 International Federation of Gynecology and Obstetrics (FIGO) staging systems for early-stage endometrial cancer based on histological subtype stratification. Methods: A retrospective cohort of 472 patients with FIGO 2009 stage [...] Read more.
Background/Objectives: We comparatively evaluated the prognostic performance of the 2009 and 2023 International Federation of Gynecology and Obstetrics (FIGO) staging systems for early-stage endometrial cancer based on histological subtype stratification. Methods: A retrospective cohort of 472 patients with FIGO 2009 stage I–II between 2004 and 2019 was analyzed. Patients were restaged using both systems. Overall survival (OS) and recurrence-free survival (RFS) were determined according to histopathological aggressiveness. Kaplan–Meier survival analysis with log-rank testing compared the performance of the systems. Cox proportional hazards regression identified independent prognostic factors. A hypothetical modification of the FIGO 2023 system was evaluated for aggressive subtypes. Results: In all, 388 patients had nonaggressive histology, and 84 patients had aggressive histology. For cases of nonaggressive histology, FIGO 2023 demonstrated superior prognostic discrimination for OS and RFS (p < 0.05), whereas FIGO 2009 showed significant stratification for OS (p < 0.001) but not RFS (p = 0.149). For cases of aggressive histology, FIGO 2009 showed significant stratification for RFS (p = 0.017) but not OS (p = 0.31), whereas FIGO 2023 showed no significant stratification for either endpoint. The hypothetical modification of the FIGO 2023 staging system showed significantly improved discrimination for RFS (p = 0.019) but not OS. Multivariate analysis identified age and lymphovascular space invasion as independent prognostic factors in nonaggressive cancers, whereas cervical stromal involvement was significant in aggressive subtypes. Conclusions: The prognostic utility of the FIGO staging system is histology dependent. Although FIGO 2023 offers enhanced risk stratification for nonaggressive endometrial cancers, its discriminatory power for aggressive subtypes remains limited, indicating the need for histology-specific refinements of future staging frameworks. Full article
(This article belongs to the Special Issue Survivorship and Quality of Life in Endometrial Cancer)
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Review

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13 pages, 258 KB  
Review
Endometrial Cancer Related to Endometrial Ablation: A Narrative Review
by George A. Vilos, Angelos G. Vilos, Meryl Hodge, Ayman Oraif, Faisal Khalid Idris, Jacob McGee and Artin Ternamian
Cancers 2026, 18(8), 1290; https://doi.org/10.3390/cancers18081290 - 19 Apr 2026
Viewed by 623
Abstract
Persistent post-endometrial ablation uterine bleeding indicates that no method of EA eliminates the entire endometrium, and post-EA hysteroscopy shows a distorted and scarred uterine cavity in the majority of patients. These observations raise concerns regarding presentation, assessment and stage of potential post-ablation endometrial [...] Read more.
Persistent post-endometrial ablation uterine bleeding indicates that no method of EA eliminates the entire endometrium, and post-EA hysteroscopy shows a distorted and scarred uterine cavity in the majority of patients. These observations raise concerns regarding presentation, assessment and stage of potential post-ablation endometrial cancer (PAEC), developing in residual endometrium pockets. To better understand these concerns, a literature search was conducted, from the introduction of EA in the 1980s through 2025, to capture reports of endometrial cancer (EC) associated with or following EA using multiple data bases, imputing search terms of EC following EA and possible combinations of first- and second-generation EA techniques associated with EC. Upon review of all publications, we identified 86 ECs associated with EA, described in 20 case reports (N = 20), four case series (N = 18), eleven cohort studies (N = 21), one registry (N = 27) and five reviews. Based on 12 relevant studies at a median follow-up of 8.5 years (range 1.9–25), 43 EC were identified in 39,795 women with a history of EA, with a summary incidence of 0.11% (range 0.0–1.59%). Although the studies and data are very heterogeneous, it appears that EA may afford a protective effect in reducing the risk of EC in the short term. The mechanistic effect is likely due to a quantitative reduction in the endometrium that can potentially become malignant, and/or due to the elimination of occult pre- or malignant endometrial elements which are vulnerable to EA. Moreover, based on 25 evaluable cases, the mode and time to presentation, the diagnostic work-up (including endometrial biopsy and hysteroscopy), and the stage of PAEC appear not to be altered by EA. Full article
(This article belongs to the Special Issue Survivorship and Quality of Life in Endometrial Cancer)

Other

Jump to: Research, Review

17 pages, 890 KB  
Systematic Review
Quality of Life Measures in Advanced Endometrial Cancer: A Systematic Review of Reporting Practices in Phase III Clinical Trials
by Justine Himpe, Marjolein Orije, Emiel A. De Jaeghere, Katrien Vandecasteele and Hannelore Denys
Cancers 2026, 18(2), 258; https://doi.org/10.3390/cancers18020258 - 14 Jan 2026
Viewed by 1071
Abstract
Background: Advanced endometrial cancer is associated with poor survival. With the advent of molecular classification and novel systemic therapies—including immunotherapy and targeted agents—treatment regimens have become increasingly complex. While these approaches aim to improve survival, they also potentially introduce long-term toxicities and treatment [...] Read more.
Background: Advanced endometrial cancer is associated with poor survival. With the advent of molecular classification and novel systemic therapies—including immunotherapy and targeted agents—treatment regimens have become increasingly complex. While these approaches aim to improve survival, they also potentially introduce long-term toxicities and treatment burden, reinforcing the importance of incorporating health-related quality of life (HRQoL) and patient-reported outcomes (PROs) into clinical trials. Methods: A systematic review was conducted of phase III randomized controlled trials (RCTs) in advanced, recurrent, or metastatic endometrial cancer evaluating systemic treatment registered on ClinicalTrials.gov and published up to 30 November 2025. Extracted data included study characteristics, HRQoL instruments, reporting formats, adherence to CONSORT-PRO, and timing of HRQoL dissemination (relative to primary efficacy reports). Results: Eight phase III RCTs published between 2020 and 2024 were included. Although HRQoL was consistently designated as a secondary endpoint, reporting within pivotal efficacy publications was limited. Most reports presented mean changes from baseline using the EORTC QLQ-C30, QLQ-EN24, and EQ-5D-5L. None of the primary reports reported time-to-deterioration analyses or the proportions of patients improving/deteriorating. Adherence to CONSORT-PRO was low, with only a minority of items addressed. Dedicated QoL publications were delayed by up to 25 months after primary efficacy reports and typically appeared in journals with lower impact factors. Conclusions: Despite routine inclusion of HRQoL measures in trial protocols, reporting remains inconsistent, limited in scope, and often delayed. Strengthening adherence to established frameworks is essential to ensure that HRQoL endpoints are predefined, analytically robust, and disseminated alongside efficacy data—particularly in a rapidly evolving therapeutic landscape. Full article
(This article belongs to the Special Issue Survivorship and Quality of Life in Endometrial Cancer)
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