Introduction Staging operations for early stage endometrial cancer are performed uniformly, despite the fact that pathologic information can be obtained prior to surgery. According to molecular categories identified in the Cancer Genome Atlas, p53 mutation and MMRd are associated with poor prognosis. If there is a correlation between the molecular profile obtained from endometrial biopsy tissue and the extent of disease after surgery, it may be possible to personalize surgical planning.

Methods This study compared the P53 and MMR status of 173 patients with newly diagnosed and clinically staged I-II endometrial cancer who underwent surgical staging, with their final pathological results. All were classified into three groups based on their molecular profiles: abnormal p53, MMRd, and NSMP (no specific molecular profile). The presence of involvement in the cervix, adnexa, and lymph nodes was analyzed using the Kruskal-Wallis test.

Results Out of 173 patients, 17(9.8%) were assigned to p53 abnormal group, 33(19.1%) to MMRd group, and 123(71.1%) to NSMP group. Among them, 18(10.4%) had cervical involvement, 8(4.6%) had adnexal involvement, and 8(4.6%) had lymph node involvement. The p-values for the involvement of each group were 0.115 for cervix, 0.328 for adnexa, and 0.860 for lymph nodes, indicating no statistically significant relationship between molecular profile and disease extent.

Conclusion/Implications Molecular profiles do not seem to determine the prognosis based on the difference in stage at first onset in early stage endometrial cancer. Staging operations should follow current guidelines, but It is necessary to make efforts to individualize treatment plans based on information obtained through preoperative histology.