Clinical Advances on Endometrial Cancer

Dear Colleagues,

Endometrial cancer is the most frequent gynecological neoplasm. Although it is a malignancy usually diagnosed in the early stages, in 2019, it caused over 12.000 deaths. Therefore, its impact is not negligible.

Risk stratification includes histological type, depth of myometrial invasion, lymphovascular space involvement, histological grading. These assessments serve better to identify women in need of only surgical treatment, or combined with radiation and systemic therapy. Currently, the study of the molecular profile is being carried out to improve the risk stratification and targeted therapy. Biomarkers and molecular alterations are increasingly being used to choose the best systemic treatment in recurrences. Immunotherapeutic drugs such as pembrolizumab and lenvatinib are studied in advanced endometrial cancer. There is a further need to identify better biomarkers that allow for guidance towards personalized therapy and combined therapeutic regimens, including immunotherapy, radiation therapy, and chemotherapy.

Surgery alone usually treats most endometrial cancers. However, even in this area, efforts should be made to limit under- and over-treatment. In this way, surgical morbidity can be reduced. For example, systematic lymphadenectomy is associated with lymphedema, lymphocele formation, and neuralgia. These surgical sequelae have a significant impact on women's quality of life. In this regard, the use of sentinel lymph node showed decreased morbidity, high sensitivity, and high negative predictive value. Many surgeons reserve its use for intermediate-high risk patients. However, about sentinel lymph node, the last ESMO-ESGO-ESTRO Consensus Conference on Endometrial Cancer reported the following grade of recommendation: moderate evidence against efficacy or for adverse outcome, generally not recommended. Therefore, further evidence is needed in this area.

This Special Issue aims to gather in one collection reviews and original contributions to illustrate recent advances in endometrial cancer and the future directions of clinical and basic research.

Prof. Andrea Ciavattini
Guest Editor

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• Endometrial cancer
• Sentinel lymph node evaluation
• Recurrent endometrial cancers
• Molecular profile
• Immunotherapy
• Chemotherapy
• Radiotherapy
• Hormonal therapy
• Imaging