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Why Cancer Stage Still Matters in Endometrial Cancer

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Surgical stage in the era of molecular profiling of endometrial cancer.DOI 10.1016j.ejca.2025.116164

Endometrial cancer begins in the lining of the uterus. In recent years, doctors have learned a lot about the genetic makeup of these tumors. This molecular testing helps group cancers by how they behave. It has improved treatment planning. Many patients now hear about their cancer’s “molecular type” soon after diagnosis.

This large European study asked an important question. Does the traditional cancer stage still matter when molecular testing is used? Cancer stage describes how far the disease has spread. Stage I means the cancer is limited to the uterus. Higher stages mean spread to nearby tissues, lymph nodes, or distant organs.

Researchers studied over 2,000 women treated across many hospitals. All stages and tumor types were included. Each cancer was placed into one of four molecular groups. The team then looked at survival and cancer return over time.

The results were clear. Cancer stage remained very important. Women whose cancer was confined to the uterus had the best outcomes, no matter the molecular group. As the cancer spread beyond the uterus, the risk of death and recurrence increased.

Lymph node involvement played a major role. When cancer reached the lymph nodes, survival dropped in most molecular groups. This showed that tumor spread still carries strong meaning, even with modern testing.

Molecular type also mattered. Some groups had better outcomes than others. Still, stage and molecular type worked together rather than replacing each other. In the most advanced stage, when cancer had spread far from the uterus, molecular differences were less helpful in predicting outcome.

For patients, this study brings clarity. Molecular testing gives valuable insight, yet surgery findings remain key. Knowing how far the cancer has spread helps guide follow-up care and treatment choices.

This research supports a balanced approach. Doctors should consider both molecular results and surgical stage. Using both pieces of information helps create a care plan that fits each person more closely. It also reassures patients that long-standing tools like staging still play an important role in modern cancer care.

DOI: 10.1016/j.ejca.2025.116164

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