Highlight
– Adjuvant chemoradiotherapy improves 10-year overall survival (74.4% vs 67.3%) and recurrence-free survival in high-risk endometrial cancer.
– Patients with p53 abnormal tumors derive the greatest survival benefit from chemoradiotherapy.
– No significant survival advantage was observed for patients with POLE-mutated or mismatch repair-deficient tumors with added chemotherapy.
– Molecular classification is critical in treatment tailoring due to differential chemotherapy benefit and toxicity considerations.