Utilization of Key Morphologic and Molecular Prognostic and Predictive Parameters in Endometrial Malignancies: A Survey of Gynecologic Pathologists

Abstract

Background:

Endometrial carcinoma is a common gynecological malignancy with rising incidence rates. While histopathological staging remains a cornerstone for treatment decisions, its limitations in addressing tumor heterogeneity and molecular complexity have led to the incorporation of molecular subtypes in recent endometrial carcinoma guidelines.

Objective:

To assess global practice patterns regarding the adoption of genomic profiling, molecular classification, and morphological assessment in endometrial carcinoma, with a focus on recent updates to the International Federation of Gynecology and Obstetrics staging system.

Methods:

A survey of 68 gynecologic pathologists from Asia, North America, and Europe was conducted, collecting data on their use of morphologic assessments, ancillary immunohistochemical (IHC) tests, and molecular characterization.

Results:

Our study indicated significant regional variations, with North American and European pathologists more likely to adopt molecular testing, such as mismatch repair (MMR) and p53 IHC, than their Asian counterparts. Despite the growing recognition of molecular subtypes, many pathologists continue to rely on traditional methods, and barriers such as resource limitations and a lack of standardized protocols hinder widespread molecular testing.

Conclusion:

Our results suggest a need for more uniform adoption of updated guidelines to improve endometrial carcinoma staging accuracy and patient outcomes. Further research and standardized protocols are necessary to ensure the effective and consistent application of molecular biomarkers in clinical practice.