Impact of Molecular Classification on Multidisciplinary Treatment Decision Making in Early-Stage Endometrial…

ObservationalJCO global oncology· Aug 2026

Impact of Molecular Classification on Multidisciplinary Treatment Decision Making in Early-Stage Endometrial Cancer: A Prospective Real-World Study From India.

Rakesh Pinninti, Haripriya Abbaraju, Krishna Mohan Mallavarapu … Senthil J Rajappa

Gynecologic CancerObservationalTreatmentQ2IF 2.9

Molecular results changed treatment far more often for TP53-abnormal tumors than others.

Impact of Molecular Classification on Multidisciplinary Treatment Decision Making in Early-Stage Endometrial Cancer: A Prospective Real-World Study From India.

Rakesh Pinninti … Senthil J Rajappa

JCO global oncology · Aug 2026

Purpose

Molecular classification has refined risk stratification in endometrial cancer and is now incorporated into the 2023 International Federation of Gynecology and Obstetrics (Federation of Gynecology and Obstetrics) staging system.

Methods

This prospective observational study included patients with surgically treated Federation of Gynecology and Obstetrics 2023 stage I to II endometrial carcinoma discussed at MDT between February 2024 and December 2025.

n = 122 patients

Results

TP53-abnormal tumors were far more likely to have their treatment changed

OR 14.70 (95% CI 5.10 to 42.10)

null 1

5.10

42.10

CI excludes the null - significant

More results

Molecular subtypes were no specific molecular profile in 55 (45.1%), mismatch repair-deficient in 41 (33.6%), TP53-abnormal in 24 (19.7%), and POLE-mutated in two (1.6%).

Integration of molecular classification changed MDT recommendations in 25 cases (20.5%), with escalation in 15 (12.3%) and de-escalation in 10 (8.2%).

More results

No treatment changes were observed in no specific molecular profile or POLE-mutated tumors.

The net incremental treatment cost was ₹11.8 lakh across the cohort; including molecular testing, the overall incremental cost was ₹34,672 per patient (∼$418 US dollars).

“

Conclusion · 1 of 2

Integration of molecular classification modified adjuvant treatment in approximately one fifth of patients.

Conclusion · 2 of 2

Changes were biologically consistent, supporting the feasibility and clinical utility of molecularly integrated MDT decision making in early-stage endometrial cancer even in resource-constrained settings.

Impact of Molecular Classification on Multidisciplinary Treatment Decision Making in Early-Stage Endometrial Cancer: A Prospective Real-World Study From India.

Impact of Molecular Classification on Multidisciplinary Treatment Decision Making in Early-Stage Endometrial Cancer: A Prospective Real-World Study From India.

Related papers