ESGO/ESTRO/ESP 2020 European societies guidelines for management of endometrial cancer: Implication for radiologists

Molecular biology is now an important part of endometrial cancer management, especially for adjuvant treatment decision. Tumours are now classified in four distinct molecular subclasses based on genomic architecture/mutational burden. These include the ultramutated subtype, defined by mutation in the exonuclease domain of DNA polymerase epsilon (POLE); the hypermutated, microsatellite-unstable subclass, with deficiency of at least one mismatch repair proteins (MMRd); the copy number high subtype, which is characterized by mutations in p53, and the copy number-low subtype that does not have a surrogate marker. These features are not yet integrated in the surgical decision, and the pre-operative imaging is still the cornerstone of the initial treatment. This review aims to summarize the ESGO/ESTRO/ESP 2020 European societies guidelines, the impact of molecular biology and the role of imaging in decision algorithms. (c) 2023 Elsevier Masson SAS. All rights reserved.