Predictive Factors and Outcomes in the Management of Stage IB Endometrial Cancer

Introduction: Endometrial cancer is one of the most common gynaecological malignancies, especially in postmenopausal women. This case study analyzes the clinical course of a 52-year-old female patient diagnosed in April 2020 with low-grade endometrioid adenocarcinoma, stage IB by the FIGO system. After total hysterectomy with bilateral salpingo-oophorectomy, the patient underwent adjuvant radiotherapy due to the presence of risk factors, such as obesity and limited myometrial invasion. Despite the favourable prognosis associated with the ultra mutated POLE molecular profile, the patient presented metastatic recurrence three years after the initial treatment. Methodology: This was a retrospective analysis of the patient's clinical data, including medical history, therapeutic interventions, and outcomes. Management of recurrence included systemic chemotherapy with carboplatin and paclitaxel, associated with palliative radiotherapy for local control. The investigation detailed the factors that contributed to clinical failure, such as obesity, characteristics of the occupational environment, and limitations of the therapeutic strategies adopted. Results: Partial control of metastatic disease, with reduced symptoms and improved quality of life during treatment of recurrence. However, the disease progressed systemically approximately 18 months after intervention, leading to death in a comprehensive palliative care setting. This case highlights the importance of integrative approaches in managing endometrial cancer, considering the interaction between clinical, molecular and psychosocial factors. Clinical failure in the presence of a favourable molecular profile reinforces the need for more personalized therapeutic strategies, including the use of immunotherapy in specific scenarios. Conclusion: The integration of innovative therapies, improved monitoring protocols, and psychosocial support are critical to optimizing outcomes in patients with gynecologic cancer. This case highlights the relevance of additional studies exploring the combination of technological advances and patient-centred care to address the challenges of this condition.