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We recommend incorporation of histotype and grade along with depth of myometrial invasion to define stage I endometrial cancer, a change from 3\u2010tier grading to binary grading, and inclusion of lymph node status (negative vs not removed) in the definition of stage I disease. Elimination of cervical involvement to define stage <jats:styled-content style=\"fixed-case\">II<\/jats:styled-content> and inclusion of positive peritoneal cytology to upstage otherwise stage I cancers to stage <jats:styled-content style=\"fixed-case\">IIA<\/jats:styled-content> is also recommended. Extrauterine pelvic involvement should be classified as stage <jats:styled-content style=\"fixed-case\">IIB<\/jats:styled-content> disease, and stage <jats:styled-content style=\"fixed-case\">III<\/jats:styled-content> should be reclassified based exclusively on retroperitoneal pelvic and\/or para\u2010aortic lymph node involvement. If feasible, molecular staging by immunohistochemistry (mismatch repair proteins and p53) as well as <jats:italic><jats:styled-content style=\"fixed-case\">POLE<\/jats:styled-content><\/jats:italic> exonuclease sequencing may be carried out in order to assign one of the four categories from The Cancer Genome Atlas.<\/jats:p>","DOI":"10.1002\/ijgo.12789","type":"journal-article","created":{"date-parts":[[2019,2,18]],"date-time":"2019-02-18T15:15:00Z","timestamp":1550502900000},"page":"245-252","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["A proposal for updating the staging of endometrial cancer"],"prefix":"10.1002","volume":"145","author":[{"given":"Amita","family":"Maheshwari","sequence":"first","affiliation":[{"name":"Department of Gynecologic Oncology Tata Memorial Centre  Mumbai India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sudeep","family":"Gupta","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology Tata Memorial Centre  Mumbai India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jaime","family":"Prat","sequence":"additional","affiliation":[{"name":"Department of Pathology Autonomous University of Barcelona  Barcelona Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2019,3,6]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(16)31012-1"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijgo.2009.02.012"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.2174\/138920211794520169"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/djn397"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(08)61766-3"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/IGC.0b013e3182a5055e"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2004.00.7617"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(08)70074-3"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9378(99)70431-X"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1038\/nature12113"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ygyno.2008.01.023"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ygyno.2014.03.567"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.3892\/or.2014.3108"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ygyno.2014.02.011"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/0090-8258(83)90111-7"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0020-7292(03)90116-0"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0142(19950101)75:1<81::AID-CNCR2820750114>3.0.CO;2-F"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0142(19901015)60:8 <2035::AID-CNCR2820601515>3.0.CO;2-8"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.1987.tb02275.x"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/0090-8258(91)90334-2"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.humpath.2004.02.007"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/0090-8258(92)90276-O"},{"key":"e_1_2_10_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/0090-8258(91)90084-I"},{"key":"e_1_2_10_25_1","doi-asserted-by":"publisher","DOI":"10.1006\/gyno.1999.5454"},{"key":"e_1_2_10_26_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1525-1438.2002.01076.x"},{"key":"e_1_2_10_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/0090-8258(91)90086-K"},{"key":"e_1_2_10_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0360-3016(02)02813-4"},{"key":"e_1_2_10_29_1","doi-asserted-by":"publisher","DOI":"10.1097\/PGP.0b013e3181846c6d"},{"key":"e_1_2_10_30_1","doi-asserted-by":"publisher","DOI":"10.1006\/gyno.1995.1005"},{"key":"e_1_2_10_31_1","doi-asserted-by":"publisher","DOI":"10.1006\/gyno.1998.5254"},{"key":"e_1_2_10_32_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2016.11.1033"},{"key":"e_1_2_10_33_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(17)30068-2"},{"key":"e_1_2_10_34_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ygyno.2017.05.027"},{"key":"e_1_2_10_35_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1525-1438.1992.02050225.x"},{"key":"e_1_2_10_36_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ygyno.2009.06.019"},{"key":"e_1_2_10_37_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ygyno.2012.09.026"},{"key":"e_1_2_10_38_1","doi-asserted-by":"publisher","DOI":"10.1038\/bjc.2015.190"},{"key":"e_1_2_10_39_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.30496"}],"container-title":["International Journal of Gynecology &amp; 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