子宫内膜癌是发达国家最常见的妇科恶性肿瘤，全球发病率和死亡率也在增长。虽然大部分病例可以通过手术成功治疗，但转移性或复发性子宫内膜癌的一线治疗选项都伴随着显著的毒副作用。异质亚组的不准确分类更加复杂化了治疗决策和临床试验结果的解读。近期分子分类的进展正在指导转移性或复发性子宫内膜癌的治疗决策。将分子特征与传统临床病理学相结合，可以减少过度治疗或不足治疗，并帮助指导适当选择治疗方案和未来研究的有效设计。本文讨论了细胞学、分子学和治疗反应方面与高级别肿瘤不同的转移性或复发性低级别子宫内膜腺癌的治疗方法。© IGCS和ESGO 2023. 在CC BY-NC下允许再次使用。由BMJ出版。

Endometrial cancer is the most common gynecologic malignancy in developed countries, with increasing incidence and mortality rates worldwide. While most cases are successfully treated with surgery, first-line treatment options for metastatic or recurrent endometrial cancer involve significant toxicities. Imprecise classification of heterogeneous subgroups further complicates treatment decisions and interpretation of clinical trial results. Recent advances in molecular classification are guiding treatment decisions for metastatic or recurrent endometrial cancers. Integrating molecular characteristics with traditional clinicopathology can both reduce overtreatment or undertreatment and help guide the appropriate choice of therapies and effective design of future studies. Here we discuss the treatment of metastatic or recurrent low-grade endometrioid adenocarcinoma of the uterine corpus, which is distinct from high-grade tumors histologically, molecularly, and in treatment response.© IGCS and ESGO 2023. Re-use permitted under CC BY-NC. No commercial re-use. Published by BMJ.