HOW MOLECULAR DIAGNOSTICS HELP ADJUST ENDOMETRIAL CANCER TREATMENT

Endometrial cancer is a disease that most commonly occurs in postmenopausal patients. Until recently, the choice of treatment extent was based solely on morphological data, but today doctors are increasingly using molecular-genetic studies.

The story of a 55-year-old patient from Taganrog is an example. In August 2025, during a routine examination, gynecologists noticed thickening of the endometrium (the inner layer of the uterus) in the context of postmenopause. Diagnostic curettage was performed, which revealed a highly differentiated endometrioid adenocarcinoma — an early form of endometrial cancer.

«At this stage, it is important not to rush into radical decisions», – explains Maria Meshkova, oncologist of the gynecological department with chemotherapy at the N. Lopatkin Scientific Research Institute of Urology and Interventional Radiology. «We sent tissue samples for molecular-genetic analysis to clarify the biological characteristics of the tumor».

The study showed the absence of a mutation in the TP53 gene, which is responsible for programmed cell death. No microsatellite instability was detected either, which can lead to impaired DNA repair. However, a mutation in the POLE gene was found, indicating a favorable prognosis for the disease. Thus, this study allowed specialists to classify this case as low risk for disease progression.

Based on the obtained data, the medical team decided to perform a laparoscopic hysterectomy with adnexa removal without lymph nodes. «Lymph node removal is indicated for groups with intermediate and high risk of lymphatic metastasis, including aggressive tumor types. It increases the duration of surgery and the risk of postoperative complications» – explains Head of the Gynecology Department with Chemotherapy, Doctor of Medical Sciences Svetlana Mukhtarulina. «In our case, this was not necessary. Molecular analysis allowed us to accurately determine the extent of the surgery».

The patient is already feeling well and is preparing for discharge. No additional treatment is required, only regular follow-up with an oncogynecologist. Such cases are not uncommon. According to the literature, in approximately 30% of cases, molecular-genetic studies allow for adjustment of the disease stage and, accordingly, the extent of surgery.

Endometrial cancer often develops in postmenopausal women, so it is important not to wait for symptoms but to undergo preventive examinations at least once a year — including a pelvic ultrasound and a gynecological check-up. You can schedule a consultation with the specialists at the Center by calling: +7 (499) 110-40-67.