最近的数据支持分子亚型诊断在子宫内膜癌（EC）中的预测性影响。我们的目标是回顾性评估EC分子亚型中接受辅助治疗的临床预后。对单个机构和基于人群的分子分类下的EC患者进行了临床预后（疾病特异性和无进展生存DSS / PFS）评估，根据接受的辅助治疗方案和2016年ESMO风险组。共评估了2472例EC，其中184例（7.4％）为POLEmut，638例（25.8％）为MMRd，1223例（49.5％）为NSMP，427例（17.3％）为p53abn。其中，该队列中的774例（34.6％）是ESMO 2016高风险人群，109例（4.8％）为晚期或转移性。对于MMRd EC患者的预后，对跨和内部分期进行了评估，发现与ESMO高风险组（P = 0.694）或ESMO高、晚期、转移性风险组组合（p = 0.852）辐射治疗单独相比，加入化疗+/-辐射并没有观察到DSS或PFS的益处。对于p53abn EC患者，使用放疗联合辅助化疗与单纯放疗相比在ESMO高风险（P = 0.007）和ESMO高、晚期和转移性风险组组合（P = 0.015）中与DSS显著延长，并且即使限于I期疾病（P <0.001）和比较浆液和非浆液组织类型时（P = 0.009），其效果依旧显著。对于任何疾病阶段的MMRd EC，加入辅助化疗似乎都没有增加任何益处，与PORTEC-3分子分析结果一致。虽然需要进行分子亚型内治疗疗效的前瞻性试验，但仍应考虑这些“实际世界”的数据来讨论辅助治疗。版权所有©2023 Elsevier Inc.。

Recent data support the predictive implications of molecular subtype assignment in endometrial cancer (EC). Our objective was to retrospectively assess clinical outcomes according to adjuvant treatment received within EC molecular subtypes.Clinical outcomes (disease-specific and progression-free survival DSS/PFS) of EC patients from a single institution and population-based cohorts that had undergone molecular classification were assessed with respect to adjuvant therapy received and 2016 ESMO risk group.2472 ECs were assessed; 184 (7.4%) POLEmut, 638 (25.8%) MMRd, 1223 (49.5%) NSMP and 427 (17.3%) p53abn. N = 774 (34.6%) of the cohort were ESMO 2016 high risk and 109 (4.8%) were advanced or metastatic. In patients with MMRd EC, assessed across and within stage, there was no observed benefit in DSS or PFS with the addition of chemotherapy +/- radiation compared to radiation alone in ESMO high risk (p = 0.694) or ESMO high, advanced, metastatic risk groups combined (p = 0.852). In patients with p53abn EC, adjuvant chemotherapy given with radiation was associated with significantly longer DSS compared to radiation alone in ESMO high risk (p = 0.007) and ESMO high, advanced and metastatic risk groups combined (p = 0.015), even when restricted to stage I disease (p < 0.001) and when compared in serous vs. non-serous histotypes (p = 0.009).Adjuvant chemotherapy is associated with more favorable outcomes for patients with p53abn EC, including stage I disease and non-serous histotypes, but does not appear to add benefit within MMRd ECs for any stage of disease, consistent with PORTEC-3 molecular subanalysis. Prospective trials, assessing treatment efficacy within molecular subtype are needed, however these 'real-world' data should be considered when discussing adjuvant treatment with patients.Copyright © 2023 Elsevier Inc. All rights reserved.