Endometrial Cancer: Biomarkers and Management

A special issue of Medicina (ISSN 1648-9144). This special issue belongs to the section "Oncology".

Deadline for manuscript submissions: 20 September 2025 | Viewed by 1600

Special Issue Editor


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Guest Editor
Department for Gynecological and Breast Oncology, University Medical Centre Maribor, 2000 Maribor, Slovenia
Interests: endometrial cancer; clinical management

Special Issue Information

Dear Colleagues,

Over the last 15 years, a substantial improvement has been observed in terms of precise diagnostics of endometrial cancer, leading to changes in clinical management. The major shift was invoked by the results of the Cancer Genome Atlas (TCGA) published. Apart from classical histopathological characteristics, the data from TCGA, followed by an evaluation of clinical performance, led to defining four subgroups of endometrial cancer (POLEmut, MSI-H, copy number high with frequent P53 mutations, and copy number low). Research work, both in a translational setting and in a clinical environment, ended up with knowledge about clinical behavior and response to adjuvant treatment within each subgroup. At last, the new 2023 FIGO staging of endometrial cancer incorporates biomarkers (p53, POLE mut, and MSI-H) for staging purposes as they better predict the outcome of the disease. Further, several biomarkers explored in endometrial cancer possess an important role in the treatment of metastatic/advanced stages. These are important targets for novel therapeutic approaches (checkpoint inhibitors with or without multi-kinase inhibitors, inhibition of cytotoxic T-lymphocyte antigen-4, PARP inhibition, inhibition of human epidermal growth factor-2 therapy, inhibition of PI3K/Akt/mTOR pathways, inhibition of cyclin-dependent kinase 4/6, etc.). It is expected in the near future that translational medicine with clinical trials on the way will enable big steps for the improvement of oncologic outcomes in patients with endometrial cancer with avoidance of overtreatment and undertreatment. However, as precision medicine advances and is associated with higher financial costs of clinical management, we should explore possible solutions for avoiding huge disparities in patients’ access to all treatment modalities and to clinical trials.

To present a review of what is known and expected in biomarker development, clinical management of endometrial cancer patients, access to novel treatment and to published results of new studies. Reviews would be focused on specific populations (e.g., the elderly, a fertility-sparing setting, and non-endometrioid cancer) and translational research (overview, what is expected in near future) as well as in targeted therapies. Reviews would also include disparities in access to clinical trials and novel therapies.

We invite you and your colleagues to submit your articles reporting on this topic. Review articles, original research articles, and case reports (only if of the highest quality and clinically important) are all welcome.

Dr. Maja Pakiž
Guest Editor

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Keywords

  • endometrial cancer
  • biomarkers
  • target therapy
  • precision medicine
  • access to clinical trials

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Published Papers (2 papers)

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Research

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12 pages, 838 KiB  
Article
Impact of Para-Aortic Lymphadenectomy on Clinically FIGO Stage IIIC1 High-Grade Endometrial Cancer: A Retrospective Cohort Study from Two Tertiary Centers in Korea and Taiwan
by Yen-Ling Lai, Jun-Hyeong Seo, Koping Chang, Hyun-Soo Kim, Jung Chen, Tyan-Shin Yang, Yu-Li Chen and Yoo-Young Lee
Medicina 2025, 61(6), 1079; https://doi.org/10.3390/medicina61061079 - 12 Jun 2025
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Abstract
Background and Objectives: The therapeutic effect of para-aortic lymphadenectomy in patients with clinically para-aortic node-negative diseases remains controversial. In this study, we investigated whether combined pelvic and para-aortic lymphadenectomy has a survival benefit compared with pelvic lymphadenectomy alone in patients with clinically [...] Read more.
Background and Objectives: The therapeutic effect of para-aortic lymphadenectomy in patients with clinically para-aortic node-negative diseases remains controversial. In this study, we investigated whether combined pelvic and para-aortic lymphadenectomy has a survival benefit compared with pelvic lymphadenectomy alone in patients with clinically FIGO stage IIIC1 high-grade endometrial cancer. Materials and Methods: We retrospectively reviewed patients with clinically FIGO stage IIIC1 high-grade endometrial cancer in the period between January 2000 and December 2020 at two tertiary centers. The patients were stratified according to type of lymphadenectomy and subgroup analyses performed. Kaplan–Meier analysis and a Cox proportional-hazards model were used to evaluate survival outcomes. Results: A total of 56 patients were identified. Of these patients, 18 underwent pelvic lymphadenectomy alone and 38 underwent combined pelvic and para-aortic lymphadenectomy. After staging surgery, 34 (60.7%) patients had pathologically confirmed lymph node metastases. Within a median follow-up of 57.5 months, there were no significant differences in recurrence-free survival (RFS) and overall survival (OS) between the two groups. In subgroup analyses, the node- and lymphovascular space invasion (LVSI)-positive patients characterized by grade 3 endometrioid histologic type (p = 0.010) or negative peritoneal washing cytology (p = 0.035) had an RFS benefit from combined pelvic and para-aortic lymphadenectomy. Conclusions: The addition of para-aortic lymphadenectomy to pelvic lymphadenectomy did not improve survival in patients with clinically FIGO IIIC1 endometrial cancer. However, para-aortic lymphadenectomy may have RFS benefit for patients with grade 3 endometrioid histologic type and positive LVSI. Full article
(This article belongs to the Special Issue Endometrial Cancer: Biomarkers and Management)
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6 pages, 1627 KiB  
Case Report
Successful Treatment of Abdominal Wall Advanced Endometriosis-Associated Clear Cell Carcinoma with AKT Pathway Inhibitor: Case Report
by Ya-Ting Ko, Ching-Hsuan Wu, Cheng-Shyong Chang, De-Wei Lai and Ta-Chih Liu
Medicina 2024, 60(12), 1946; https://doi.org/10.3390/medicina60121946 - 26 Nov 2024
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Abstract
The emergence of endometriosis-associated clear cell carcinoma (CCC) within the abdominal wall is a notably rare phenomenon. This condition predominantly impacts females who have previously undergone surgical interventions, including hysterectomy or caesarean section (C-section), with the malignant transformation of endometriosis within the post-surgical [...] Read more.
The emergence of endometriosis-associated clear cell carcinoma (CCC) within the abdominal wall is a notably rare phenomenon. This condition predominantly impacts females who have previously undergone surgical interventions, including hysterectomy or caesarean section (C-section), with the malignant transformation of endometriosis within the post-surgical abdominal scar posited as a likely mechanism. Herein, we delineate a distinctive case of endometriosis-associated CCC emanating from the abdominal wall. The therapeutic approach for the patient encompassed surgical resection, complemented by a regimen of adjuvant chemotherapy, radiotherapy, immunotherapy, and targeted therapy. Despite these measures, the patient experienced disease progression, manifested by bilateral inguinal lymph node involvement and metastasis to the left femoral bone. Advanced molecular diagnostics, specifically next-generation sequencing (NGS) of the resected specimen, identified a targetable PIK3CA E726K mutation. Subsequent treatment with alpelisib and everolimus was initiated, culminating in a sustained complete response. Full article
(This article belongs to the Special Issue Endometrial Cancer: Biomarkers and Management)
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