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Clinical calculator summary

ESGO/ESTRO/ESP 2021 molecular-unknown risk groups

A categorical postoperative clinicopathologic table using FIGO 2009 stage when molecular classification is unavailable.

Evidence-based context for fast calculator use

Purpose:
Interpret the source-defined prognostic group without deriving stage, molecular class, probability, or treatment.
Population:
Adults with primary endometrial carcinoma, final postoperative FIGO 2009 pathology, and unknown or unavailable molecular classification.
Factors:
FIGO 2009 stage, Histologic type, FIGO grade group, LVSI extent, Myometrial invasion, Residual disease
Reference:
Concin N, et al. Int J Gynecol Cancer. 2021. DOI 10.1136/ijgc-2020-002230. PMID 33604759.
HomeESGO/ESTRO/ESP 2021 Endometrial Risk Groups - Molecular Classification Unknown
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ESGO/ESTRO/ESP 2021 Endometrial Risk Groups - Molecular Classification Unknown

Clinical Context & Background

This route implements the clinicopathologic risk-group table in the ESGO/ESTRO/ESP 2021 endometrial carcinoma guideline for cases where molecular classification is unknown or unavailable. It is explicitly not an ESMO score and does not implement the 2025 update using FIGO 2023.
The route requires final postoperative FIGO 2009 stage, histologic type, grouped FIGO grade, externally reported LVSI extent, myometrial invasion, and residual-disease status. Grade 1-2 is represented as low grade and grade 3 as high grade; negative and focal LVSI remain distinct input values but share source-table branches. Stage and pathology are accepted as externally assigned facts and are not derived.
The output is a historical prognostic group only. It is not a treatment prescription, individualized probability, stage derivation, molecular classifier, or substitute for the complete guideline and multidisciplinary interpretation.
Primary Source EvidenceConcin N, Matias-Guiu X, Vergote I, et al. ESGO/ESTRO/ESP guidelines for the management of patients with endometrial carcinoma. Int J Gynecol Cancer. 2021;31:12-39. DOI 10.1136/ijgc-2020-002230. PMID 33604759.
Formula Logic
Hierarchical lookup in the ESGO/ESTRO/ESP 2021 molecular-classification-unknown table using FIGO 2009 postoperative pathology; no arithmetic score.

Reference Data

Source-defined groupClinicopathologic table context
Low riskSelected stage I endometrioid low-grade states
Intermediate riskSelected stage I endometrioid or non-endometrioid states
High-intermediate riskStage II and selected stage I endometrioid states
High riskStage III-IVA without residual disease and invasive non-endometrioid states
Advanced/metastaticStage III-IVA with residual disease or stage IVB

Clinical Workflow

Use, Interpret, And Continue The Patient Pathway

Expand for workflow guidance, limitations, examples, and related next steps.

When To Use

  • After final postoperative pathology for primary endometrial carcinoma has established every required clinicopathologic field.
  • Only with FIGO 2009 stage and when molecular classification is unknown or unavailable.

How To Interpret

  • Read the returned low, intermediate, high-intermediate, high, or advanced/metastatic group as the source-table classification.
  • A neutral incomplete, outside-scope, invalid, or not-classifiable result means no group was assigned.

What To Do Next

  • Use the actual pathology report and complete current guideline context for clinical decisions; this interpreter does not prescribe treatment.

Limitations

  • Does not accept FIGO 2023, the 2025 framework, or a known molecular classification.
  • Does not derive stage, histology, grade, LVSI, invasion, residual disease, or molecular class.
  • Does not calculate recurrence probability, survival, treatment benefit, or a management recommendation.
  • Stage I-II residual disease is withheld as not classifiable from this source table.

Validated Population

The implementation is source-locked to the ESGO/ESTRO/ESP 2021 molecular-unknown FIGO 2009 clinicopathologic table.

Calculation verification history

Verified

  1. : Production browser revalidation

    • Three source-backed cases passed through the visible production controls across Low risk, Intermediate risk, and Advanced/metastatic groups.
    • The FIGO 2009 molecular-unknown rule identifiers R11, R09, and R01 matched the ESGO/ESTRO/ESP 2021 table.
    • No unexpected N/A, stale control, literal undefined/null value, or browser-console error was observed.
    Download latest production check (Excel)

    Case-level evidence is retained in validation/browser-revalidation/esmo-endometrial-risk-2026-08-03.json.

  2. : Production browser validation

    • Ten source-backed cases were entered and submitted through the visible production controls at oncotoolkit.com across 11 Calculate attempts; all ten calculation and UI cases matched their expected dispositions.
    • The matrix covered all five prognostic groups, endometrioid and non-endometrioid branches, LVSI and residual-disease precedence, Stage IA through IVB examples, a blocked Stage-IB contradiction, and reset/repeat behavior without stale state.
    • Overall browser status was failed-console because production route loads emitted minified React hydration error #418; no calculator-specific console error or calculation mismatch was observed.

    Case-level production evidence is retained in validation/browser-production/esmo-endometrial-risk.json.

  3. : Model identity corrected

    • Corrected the route identity from ESMO to ESGO/ESTRO/ESP 2021 and locked it to FIGO 2009 with molecular classification unknown or unavailable.
    • The 2025 framework remains excluded because it uses FIGO 2023 and a different risk framework; known-molecular pathways also remain excluded.

  4. : Scope and classification corrected

    • Replaced favorable defaults and a four-field treatment tree with an immutable exact eleven-key postoperative pathology contract.
    • Restored all five source groups, exact residual-disease precedence, six histology options, separate focal/substantial LVSI, and neutral incomplete, outside-scope, invalid, and not-classifiable states.
    • Removed treatment, probability, and clinical-validation claims.

  5. : Full validation completed

    • Passed 3072 of 3072 deterministic assertions using a separately encoded literal oracle.
    • Workbook and complete JSON evidence were mirrored publicly after report checks passed.

    Software implementation verification only; not prospective clinical validation.

Verification confirms the calculator implementation against the cited model; it is not independent clinical validation, regulatory approval, or medical advice.

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Frequently Asked Questions

When should ESGO/ESTRO/ESP 2021 Endometrial Risk Groups - Molecular Classification Unknown be used?

Use it for patients undergoing ovarian, cervical, endometrial, or gestational-trophoblastic risk and staging assessment when all required inputs and the intended clinical setting are confirmed.

Can ESGO/ESTRO/ESP 2021 Endometrial Risk Groups - Molecular Classification Unknown determine treatment by itself?

No. Interpret the result with the cited evidence, complete clinical assessment, current guidelines, and patient-specific goals.

Evidence-based oncology decision support. Verify with clinical guidelines.