Molecular Profiling to Guide Fertility Sparing Therapy in Early-Stage Endometrial Cancer: A EORTC Gynaecological Cancer Group Study

Abstract

Simple Summary Preserving fertility is an important treatment option for young women with early-stage endometrial cancer who wish to have children in the future. However, not all patients respond equally well, and some experience disease persistence or recurrence. Recent advances have shown that endometrial cancer can be divided into different molecular groups, which may respond differently to treatment. In this study, we reviewed all available published evidence to investigate whether these molecular groups are associated with the success of fertility-preserving treatment. We analysed data from 457 patients, included in ten studies. Women with one molecular group had the highest treatment response rates, whereas two other groups had lower response rates and were more likely to experience disease progression. Information on pregnancy outcomes was limited, high lighting the need for further research. Our findings suggest that molecular classification may help identify patients who are more likely to benefit from fertility-preserving treatment, supporting more personalised counselling and treatment decisions while maintaining a careful balance between cancer control and future reproductive goals.