Molecular Classification of Endometrial Cancer with Drs. Ilaria Betella and Francesco Multinu

In this episode of the IJGC podcast, Editor-in-Chief Dr. Pedro Ramirez is joined by Drs. Ilaria Betella and Francesco Multinu. Dr. Betella is an attending in the Department of Gynecologic Surgery at the European Institute of Oncology (IEO) in Milan. Her research focuses on molecular classification of endometrial cancer and on hereditary gynecologic cancer syndromes. Dr. Multinu is a gynecologic oncologist at the European Institute of Oncology (IEO) in Milan as well as a research collaborator in the Department of Obstetrics and Gynecology, Division of Gynecologic Surgery at the Mayo Clinic in Rochester, Minnesota. His special research interests include surgical and postoperative treatment of endometrial cancer. Highlights: - There is evidence that the new molecular classification will be the future in the management of endometrial cancer. - The implementation of molecular analysis allows oncologists to reallocate to a different risk class 6.8% of endometrial cancers that otherwise would have been misclassified and consequently undertreated or overtreated. - The interpretation of molecular classification requires a validated hierarchical algorithm, for which POLE analysis is essential: Even though POLE testing has not been implemented in many institutions, there is no way to use part of the molecular analysis and completely escape POLE analysis.

- According to the new algorithm proposed by Dr. Betella et al., POLE analysis could be spared in 67% of patients and reserved only for those in whom the incorporation of the molecular classification could change the risk class attribution and post-operative management.