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Aligning the treatment of endometrial cancer to FIGO stage based on European and American guidelines

  • Enrique Hernandez1,*,
  • Brandon Fox1
  • Jeremy G. Price1

1Lewis Katz School of Medicine at Temple University and Temple Health Fox Chase Cancer Center, Philadelphia, PA 19072, USA

DOI: 10.22514/ejgo.2025.125 Vol.46,Issue 10,October 2025 pp.1-4

Submitted: 21 July 2025 Accepted: 20 August 2025

Published: 15 October 2025

*Corresponding Author(s): Enrique Hernandez E-mail: Enrique.hernandez@temple.edu

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Abstract

In 2023 the International Federation of Gynecology and Obstetrics (FIGO) updated the endometrial cancer staging to better align with prognosis and therapy. We present an approach to treatment of patients with endometrial cancer based on their FIGO stage utilizing the European and American evidence-based treatment guidelines. The major difference between the American and European guidelines is that the American guidelines still utilize anatomic stage and histologic type, while the European guidelines have incorporated tumor molecular profile in their risk stratification. Another major difference is that for FIGO stage IC, the American guidelines recommend vaginal brachytherapy with or without chemotherapy, while the European guidelines recommend no adjuvant therapy.


Keywords

FIGO; Staging; Endometrial cancer; Treatment guidelines


Cite and Share

Enrique Hernandez,Brandon Fox,Jeremy G. Price. Aligning the treatment of endometrial cancer to FIGO stage based on European and American guidelines. European Journal of Gynaecological Oncology. 2025. 46(10);1-4.

URL:

https://www.ejgo.net/articles/10.22514/ejgo.2025.125

References

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[2] Concin N, Matias-Guiu X, Vergote I, Cibula D, Raza Mirza M, Marnitz S, et al. ESGO/ESTRO/ESP guidelines for the management of patients with endometrial carcinoma. International Journal Gynecologic Cancer. 2021; 31: 12–39.

[3] Harkenrider MM, Abu-Rustum N, Albuquerque K, Bradfield L, Bradley K, Dolinar E, et al. Radiation therapy for endometrial cancer: an american society for radiation oncology clinical practice guideline. Practical Radiation Oncology. 2023; 1: 41–65.

[4] National Comprehensive Cancer Network. Uterine neoplasms (Version 3.2025). 2025. Available at: https://www.nccn.org/professionals/physician_gls/pdf/uterine.pdf (Accessed: 21 August 2025).

[5] Eskander RN, Sill MW, Beffa L, Moore RG, Hope JM, Musa FB, et al. Pembrolizumab plus chemotherapy in advanced endometrial cancer. New England Journal of Medicine. 2023; 388: 2159–2170.

[6] Mirza MR, Chase DM, Slomovitz BM, Christenson RD, Novák Z, Black D, et al. Dostarlimab for primary advanced or recurrent endometrial cancer. New England Journal of Medicine. 2023; 388: 2145–2158.

[7] Gaffney D, Matias-Guiu X, Mutch D, Scambia G, Creutzberg C, Fotopoulou C, et al. 2023 FIGO staging system for endometrial cancer: the evolution of a revolution. Gynecologic Oncology. 2024; 184: 245–253.

[8] Leitao Jr MM. 2023 changes to FIGO endometrial cancer staging: counterpoint. Gynecologic Oncology. 2024; 184: 146–149.

[9] Concin N, Matia-Guiu X, Cibula D, Colombo N, Creutzberg CL, Lederman J, et al. ESGO-ESTRO-ESP guidelines for the management of patients with endometrial carcinoma: update 2025. The Lancet Oncology. 2025; 26: e423–e425.


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