SEOM-GEICO clinical guidelines on endometrial cancer (2025)

Endometrial cancer (EC) is the most common gynecological malignancy in developed countries. Although most cases are diagnosed at an early stage, prognosis in case of relapse or metastasis remains poor. Molecular characterization of EC is highly recommended as it allows more accurate risk stratification and may modify treatment recommendations. The updated FIGO 2023 staging of EC highlights the importance of traditional clinicopathological factors, while underlining the need for molecular classification to predict outcomes. In early-stage EC, standard treatment consists of total hysterectomy and bilateral salpingo-oophorectomy. Lymph node evaluation remains controversial, as the benefits of systematic lymphadenectomy are unclear. Adjuvant treatment, consisting of radiotherapy, brachytherapy, and chemotherapy, should be chosen according to risk category. In women with advanced or recurrent EC, the combination of carboplatin and paclitaxel has long been standard treatment. However, therapeutic options have changed recently due to advances in immunotherapy. The aim of this guideline is to summarize the current evidence for the diagnosis, treatment, and follow-up of EC, and to provide evidence-based recommendations for clinical practice.