Management of endometrial cancer: current insights and future directions

Endometrial cancer rate is increasing worldwide during the last decades (1). In most of the cases, endometrial cancer has a well or moderately differentiated endometrioid histotype at early-stage with a good prognosis. Nevertheless, the evaluation of lymph node status through pelvic and selective para-aortic node dissection (2,3) is an invaluable prognostic factor for targeted adjuvant treatment (4,5). In this scenario, novel strategies are arising in order to make diagnosis as earlier as possible (6), and provide appropriate management for these patients, taking into account the possibility of tailored treatment, even by minimally invasive approach (7). Indeed, the preoperative assessment (8,9) with imaging techniques (10) and endometrial biopsy (11) allows the definition of endometrial cancer stage and grade and its appropriate management (12), especially taking into account potential risk factors (13-15). In this regard, the current role of hysteroscopy for targeted endometrial biopsy (16) is pivotal to minimize misdiagnosis of endometrial cancer and erroneous tumor grading classification (17).

Endometrial cancer may occur in reproductive age, and fertility preservation approaches are mandatory in this population (18) and represent a current challenge (19). This element is of paramount importance, since the surgical treatment, as well as adjuvant strategies, may play all a detrimental role on psychological condition of the woman (20) and should be balanced between radicality and preservation of fertility potential. In addition, the search for novel and cost-effective biomarkers (21) are shedding new lights on the topic (22), aiming to identify patients with high-risk of recurrence (23) after radical treatment.

In this scenario, the articles published in this special series can be considered a significant step forward in our knowledge about endometrial cancer and stimulate further discussion among the readers. In particular, the novel pieces of information contained in these articles may lead to important changes in the clinical practice and potential paradigm shifts in the future management of endometrial cancer.

Antonio Simone Laganà

Acknowledgments

Funding: None.

Footnote

Provenance and Peer Review: This article was commissioned by the editorial office, Translational Cancer Research, for the series “Endometrial Cancer”. The article did not undergo external peer review.

Conflicts of Interest: The author has completed the ICMJE uniform disclosure form (available at http://dx.doi.org/10.21037/tcr-2020-ec-15). The series “Endometrial Cancer” was commissioned by the editorial office without any funding or sponsorship. ASL served as the unpaid Guest Editor of the series, and serves as an unpaid editorial board member of Translational Cancer Research from Dec 2019 to Nov 2021. The author has no other conflicts of interest to declare.

Ethical Statement: The author is accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0/.

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