Treatment of endometrial carcinoma in Germany
Modern methods of treating endometrial carcinoma: from early diagnosis to personalized therapy
Endometrial carcinoma (endometrial cancer) is a malignant tumor of the uterine mucosa, occupying 1st place among gynecological cancers in developed countries. Clinics in Germany use organ-preserving techniques in the early stages and complex therapy for common forms, achieving a 5-year survival rate of up to 95% with timely treatment.
Symptoms of endometrial carcinoma
Early signs:
- Abnormal bleeding (90% of cases)
- Watery discharge mixed with blood
- Bloody discharge during menopause
Late symptoms:
- Pelvic pain
- Urinary dysfunction
- Weight loss
- Swelling of the legs (with metastases to the lymph nodes)
Diagnosis of endometrial carcinoma at RheinRegio Klinik Zentrum
- Hysteroscopy with biopsy is the gold standard
- MRI of the pelvis – assessment of the depth of invasion
- PET-CT – search for metastases
- Genetic testing (for Lynch syndrome)
- Immunohistochemistry (detection of progesterone/estrogen receptors)
Each direction is supervised by advanced oncologists.
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Classification and stages of endometrial carcinoma
Histological types:
- Endometrioid (75-80%, best forecast)
- Serous (aggressive, similar to ovarian cancer)
- Clear cell (rare, high grade)
- Others (sarcomatous, mixed)
Stages (FIGO 2023):
- I: Tumor in the body of the uterus
- II: Spread to the cervix
- III: Adnexal/peritoneal/lymph node involvement
- IV: Metastases to distant organs
Degree of differentiation (G):
- G1 (highly differentiated)
- G2 (moderate)
- G3 (low differentiated)
Molecular subtypes (ESMO 2022):
- POLE-mutated (best forecast)
- MSI-H (response to immunotherapy)
- p53-mutated (aggressive)
Note: Staging includes MRI/PET-CT and histology.
Treatment options for endometrial carcinoma
Surgery
- Laparoscopic hysterectomy (for stage I)
- Robot-assisted surgery Da Vinci
- Sentinel lymph node biopsy (instead of complete lymph node dissection)
Radiation therapy
- Brachytherapy (intracavitary irradiation)
- IMRT – gentle pelvic irradiation
Drug therapy
- Hormonal treatment (for receptor-positive tumors)
- Immunotherapy (pembrolizumab for MSI-H tumors)
- Targeted drugs (lenvatinib, trastuzumab)
Survival prognosis
5-year survival rate (FIGO 2023):
- Stage I:
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IA (G1–G2): 90–95%
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IB (G3): 80–85%
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- Stage II: 70–75%
- Stage III: 40–60%
- Stage IV: 10–20%
Key prognosis factors:
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Histological type:
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Endometriotic (best prognosis)
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Serous/clear cell (aggressive)
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Molecular subtype:
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POLE mutation: >95% (I–II grade)
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MSI-H: good response to immunotherapy
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p53 mutation: high risk of relapse
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- Depth of myometrial invasion (<50% is better)
- No lymph node involvement
Unfavorable factors:
- Poorly differentiated tumor (G3)
- Damage to the lymphovascular space
- Metastases to the peritoneum/omentum
Note: Modern therapy (chemoradiotherapy, immunotherapy for MSI-H) improves outcomes in advanced stages.
Do you need advice from a German specialist?
Send us a histological report to create an individual treatment plan.
Our clinics
The association of clinics RheinRegio Klinik Zentrum offers the organization of treatment of endometrial carcinoma in Germany without intermediaries, providing access to the country’s leading oncology clinics. We combine advanced techniques, an individual approach and the highest level of medical care, giving hope even in difficult cases.
Why RheinRegio Klinik Zentrum?
- Gynecological oncologists with 20+ years of experience
- Organ-conserving surgeries for young patients
- The most precise brachytherapy with 3D planning
- Genetic analysis of the tumor
- Reconstructive surgery after radical surgery
