# Recommendations for the treatment of endometrial cancer in settings with limited resources: report from the International Gynecological Cancer Society consensus meeting

**Authors:** Fernando Cotait Maluf, Francinne T. Tostes, Henrique Alkalay Helber, Ligia A Maluf, Juliana Karassawa Helito, Renato Moretti Marques, Graziela Z. Dal Molin, Bruno Roberto Braga Azevedo, David Isla Ortiz, David Cantu, Agnaldo Lopes Silva Filho, Angélica Nogueira Rodrigues, Reitan Ribeiro, Georgia Fontes Cintra, Gustavo Guitmann, Andreia Cristina de Melo, Eduardo Paulino, Glauco Baiocchi, Leandro Santos de Araujo Resende, Michelle Samora de Almeida, Diocesio Pinto, Julio Lau de la Vega, Florencia Noll, Juliana Rodriguez, Fabio Fin, Andre Lopes, Miguel Enrique Matute Correa, Joseph S. Ng, Daniel Sanabria, Gabriel Rendon, Fernando Heredia, Ana Paula E. Galerani Lopes, Myriam Beatriz Perotta Mussi, Marcin Stanisław Bobiński, Milagros Perez Quintanilla, Jimena Meymar, David Atallah, Audrey Tsunoda

PMC · DOI: 10.3389/fonc.2026.1676000 · 2026-03-06

## TL;DR

Experts from around the world created treatment recommendations for endometrial cancer in low-resource settings to improve global patient care.

## Contribution

Developed practical endometrial cancer treatment guidelines for low- and middle-income countries with limited resources.

## Key findings

- 18 out of 109 questions reached consensus among the panel members.
- 43 additional questions were decided by majority vote.
- Recommendations were tailored to address resource limitations in cancer care.

## Abstract

Given the high disparities present in cancer care worldwide and even more challenging infrastructure and access for low- and middle-income countries, adhering precisely to international guidelines has become a challenging and complex task. Recommendations from an independent multidisciplinary panel of experts from 13 countries, including medical oncologists, pathologists, surgeons, and radiation oncologists, who met during IGCS to address some of these challenges.

The panel met in New York City in September of 2022 during the International Gynecological Cancer Society Congress and was composed of specialists from developing countries in Africa, Asia, Eastern Europe, Latin America, and the Middle East. The panel addressed 103 questions and provided recommendations for the management of early, locally advanced, recurrent, and/or metastatic endometrial cancer. The questions were carefully developed by the group and specifically directed to, and answered by, specialists according to their respective areas of expertise. Consensus was defined as at least 75% of the voting members selecting a particular recommendation, whereas a majority vote was considered when one option garnered between 50.0% and 74.9% of votes. Resource limitation was defined as any issues limiting access to qualified surgeons, contemporary imaging or radiation-oncology techniques, antineoplastic drugs, or funding for providing modern medical care.

Eighteen of the 109 (16.5%) questions presented to the panel reached consensus, whereas a majority vote was reached for 43 (39.4%) additional questions. The recommendations for the remaining questions were considerably heterogeneous and were considered experts opinion only.

Establishing guidelines with recommendations in areas with resource limitations may help healthcare providers and improve patient care around the world.

## Linked entities

- **Diseases:** endometrial cancer (MONDO:0002447)

## Full-text entities

- **Diseases:** endometrial cancer (MESH:D016889), Cancer (MESH:D009369)
- **Species:** Homo sapiens (human, species) [taxon 9606]

## Figures

9 figures with captions in the complete paper: https://tomesphere.com/paper/PMC13002782/full.md

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Source: https://tomesphere.com/paper/PMC13002782