June brought a notably full month of uterine and endometrial cancer research, with new meta-analysis data strengthening the case for immunotherapy combinations in advanced disease, a fresh look at how staging and surgical decisions are evolving under the updated FIGO 2023 system, and some of the most substantive work yet on the survivorship experience, particularly the ways that discrimination and cumulative stress affect outcomes in ways medicine is only beginning to measure. *The papers highlighted here represent a selection of those published during the month. The papers were selected and summarized by AI. Accuracy of the summaries was confirmed by a scientist.* This digest incorporates only open-access research articles that are free to be read by the entire community and that are explicitly licensed to be shared and reused. --- **Immunotherapy plus chemotherapy: the first-line evidence keeps growing** The clearest signal from June's literature is that combining immune checkpoint inhibitors (drugs that release the immune system's "brakes" on attacking cancer with platinum-based chemotherapy significantly extends survival in advanced endometrial cancer, especially in tumors with a repair defect called mismatch repair deficiency (dMMR). - A comprehensive systematic review and meta-analysis pooling ten randomized controlled trials and more than 4,000 patients found that adding a PD-1 or PD-L1 inhibitor (the class of immune checkpoint drugs that includes pembrolizumab and dostarlimab) to first-line chemotherapy extended median overall survival from 29.1 months to 43.7 months and median progression-free survival from 10.2 to 14.6 months. The overall survival benefit was statistically significant in dMMR tumors; in mismatch repair-proficient (pMMR) tumors (those without the repair defect) the combination still improved progression-free survival, though overall survival benefit was less clear-cut. ([Read the full paper](https://doi.org/10.3389/fimmu.2026.1846834)) --- **Carcinosarcoma: more aggressive than it looks, but chemoradiation may close the gap** Uterine carcinosarcoma, a rare and aggressive mixed tumor type, is harder to predict and treat than its more common counterpart, grade 3 endometrioid adenocarcinoma, but new data suggest a combined approach may level the playing field. - A retrospective study comparing 43 people with carcinosarcoma to 62 with grade 3 endometrioid cancer found that carcinosarcoma was associated with significantly worse five-year progression-free survival (35.6% versus 63.4%), particularly for stage IA disease where median progression-free survival was only 7.7 months. But notably, among patients who received combined chemoradiotherapy, survival was nearly identical between the two groups (72.7% versus 70.0% at five years), suggesting that aggressive adjuvant treatment may overcome the inherent disadvantage. Carcinosarcoma also spread in a different pattern: less likely to invade the muscle wall deeply, but more likely to spread via the peritoneal fluid. These findings underscore that conventional surgical markers of severity are less predictive for carcinosarcoma than for other endometrial cancers. ([Read the full paper](https://doi.org/10.1007/s00432-026-06523-8)) --- **Staging gets more precise, but MRI has catching up to do** The 2023 International Federation of Gynecology and Obstetrics (FIGO) staging system, which now integrates molecular tumor features alongside conventional surgical findings, is proving more accurate at predicting outcomes than its 2009 predecessor, but it's also harder to predict from imaging alone. - A validation study of 400 patients treated at a single center confirmed that the 2023 FIGO system better distinguished intermediate from advanced disease, with a statistically improved concordance index for both disease-free and overall survival. Importantly, the revised system allowed molecular markers to reclassify 15% of patients, shifting 18 patients to a lower stage and 17 to a higher one. This means that without molecular testing, risk would have been misjudged in about one in seven people. ([Read the full paper](https://doi.org/10.1590/1806-9282.20251624)) --- **The case for sentinel node mapping over full lymph node dissection holds up in high-risk disease** One of the most contested surgical questions in endometrial cancer is whether a targeted sentinel lymph node biopsy (removing only the first node or nodes that drain from the tumor) is safe enough to replace full lymph node removal in patients with high-risk disease. - A meta-analysis including 13 retrospective studies and more than 9,000 patients found no significant difference in recurrence rates or mortality between sentinel node mapping and full lymphadenectomy in patients with high-risk or high-intermediate-risk endometrial cancer. Subgroup analyses by histology type, including carcinosarcoma, serous, and clear cell, also showed no increased mortality with the targeted approach. Sentinel mapping is associated with fewer complications and better quality of life, so these findings add to a growing body of evidence that a more limited surgical approach is safe for most patients, though prospective studies are still needed. ([Read the full paper](https://doi.org/10.1016/j.jmig.2026.01.019)) --- **Who is actually at low risk for spread and might they safely skip full staging?** A recurring clinical question is whether some people with early-stage endometrial cancer need extensive lymph node staging surgery at all. - A study of 250 patients with endometrioid-type tumors found that people with grade 1 disease (the least aggressive histologic grade) and a tumor smaller than 3 cm had a spread rate outside the uterus of just 3.3%, compared to 15.3% for grade 2 and 13.3% for tumors larger than 3 cm. On multivariate analysis, higher grade and larger tumor size were both independent predictors of extrauterine metastasis. The findings support the idea that a carefully defined low-risk group (grade 1, small tumors with less than half the muscle wall invaded) may be safely spared comprehensive staging surgery, though the study was retrospective and external validation is needed before this changes practice. ([Read the full paper](https://doi.org/10.1097/MD.0000000000049188)) --- **Radiation therapy after surgery: still valuable in intermediate-high-risk early-stage disease** Whether adjuvant radiation (radiation given after surgery to reduce recurrence risk) benefits all early-stage patients equally has been an evolving question, especially as molecular subtyping becomes more common. - A retrospective review of 131 patients with stage I–II endometrial cancer classified as intermediate-risk (IR) or high-intermediate-risk (HIR) without molecular profiling found that adjuvant radiation was associated with a statistically significant improvement in progression-free survival in the HIR group, but not in the IR group. In the HIR cohort, adjuvant radiation and age over 60 were both independent prognostic factors for progression-free survival. This analysis is a reminder that even without molecular classification, which is not yet universally available, risk-stratification tools can still guide adjuvant therapy decisions in real-world practice. ([Read the full paper](https://doi.org/10.3346/jkms.2026.41.e176)) --- **Uterine sarcomas: surgery remains the cornerstone, but it has to be done right** Uterine sarcomas, which include leiomyosarcoma, endometrial stromal sarcoma, and carcinosarcoma, are rare, aggressive, and far less studied than endometrial carcinoma. - A comprehensive narrative review synthesizing current evidence on surgical management across all uterine sarcoma subtypes reinforced that complete surgical resection without tumor fragmentation or involved margins is the non-negotiable goal. The authors highlighted that leiomyosarcoma and endometrial stromal sarcoma together account for over 80% of cases, that histologic grade is the single most important prognostic factor, and that treatment should be individualized by histologic subtype, stage, and molecular profile at a center with expertise in these rare tumors. For patients who have been told they have a uterine sarcoma, this review is a practical framework for understanding what questions to ask about surgical approach and adjuvant treatment. ([Read the full paper](https://doi.org/10.3390/cancers18121870)) --- **Uterine carcinosarcoma and molecular classification: early patterns in a rare, aggressive cancer** Even within carcinosarcoma, molecular features may predict survival, and this matters for thinking about who might benefit from immunotherapy. - A study of 51 patients with uterine carcinosarcoma found that those with tumors classified as p53-wild-type and mismatch repair-deficient had the best outcomes (mean overall survival of 92.9 months, 33.3% mortality), while those with p53-abnormal and mismatch repair-intact tumors fared worst (mean OS 54.4 months, 62.5% mortality). Statistical differences between subgroups did not reach significance in this small cohort, but the directional trends are clinically meaningful and align with patterns seen in endometrial carcinoma. The authors noted that molecular stratification could inform both risk assessment and selection for immunotherapy in this understudied disease. ([Read the full paper](https://doi.org/10.3390/medicina62061135)) --- **PCOS and endometrial cancer risk: a critical evidence gap gets a systematic review** Polycystic ovary syndrome (PCOS, a hormonal condition involving irregular ovulation) is a recognized risk factor for endometrial cancer because of the prolonged estrogen exposure it causes, but there's no consensus on when or how to screen affected individuals. - A registered systematic review protocol aims to determine the effectiveness of screening for endometrial hyperplasia (precancerous thickening of the uterine lining) and endometrial cancer in premenopausal women with PCOS, compared with no screening. The review will focus particularly on people who have no symptoms, a population that current guidelines don't routinely recommend testing for. Results are expected to help clarify whether and when asymptomatic individuals with PCOS should be offered surveillance. ([Read the full paper](https://doi.org/10.1136/bmjopen-2026-119713)) --- **Muscle loss before immunotherapy is associated with worse outcomes** A new factor in predicting who benefits from immune checkpoint inhibitor therapy may be body composition, specifically, the amount of skeletal muscle a person has before starting treatment. - A retrospective analysis of 20 people with endometrial cancer treated with immune checkpoint inhibitors found that pre-treatment skeletal muscle loss (measured using CT scans) was significantly associated with worse overall survival. Each one-unit decrease in the skeletal muscle index was associated with a 64% increase in the hazard of death. Among people who were not sarcopenic at the start of treatment, muscle loss was a particularly strong predictor of poor outcomes. This is preliminary data from a small study, but it raises the question of whether muscle health and interventions like exercise or nutrition support should be assessed and optimized before immunotherapy begins. ([Read the full paper](https://doi.org/10.1111/jog.70362)) --- **Endometrial cancer located at the uterine isthmus carries a worse prognosis** Most endometrial cancers arise in the upper part of the uterus (the fundus), but a small proportion start at the isthmus, the narrower lower segment, and may behave differently. - A retrospective SEER database analysis found that isthmus cancers were diagnosed at a younger age, were more often diagnosed at advanced stages, and more frequently involved non-endometrioid (higher-risk) histology compared to fundal cancers. Three-year overall survival was significantly lower for isthmus cancer. The authors suggest that the location of the tumor within the uterus may be an underappreciated prognostic variable, though more research is needed before this changes staging or treatment recommendations. ([Read the full paper](https://doi.org/10.1002/cam4.72015)) --- **Discrimination and medical mistrust create real barriers to survivorship care** Among the most impactful papers this month is a population-level study that directly measures how experiences of discrimination shape endometrial cancer survivors' trust in the healthcare system and, by extension, their engagement with survivorship care. - A study using enrollment data from the Carolina Endometrial Cancer Study, which included 907 survivors (35% Black, mean age 60.9 years), found that nearly half reported moderate or high levels of everyday discrimination. People with high perceived discrimination had a 26% higher prevalence of medical mistrust compared to those reporting low discrimination. This pattern was consistent across racial, educational, and geographic subgroups. The findings make clear that discrimination is not merely a background social factor - it is directly shaping whether survivors trust their care teams and, by extension, whether they engage with survivorship follow-up and support. The authors call for culturally responsive survivorship care and equity-focused interventions to rebuild trust. ([Read the full paper](https://doi.org/10.1002/cam4.72051)) --- **Cumulative physiologic stress is associated with worse survival and it falls unequally** A large single-institution study links "allostatic load" (a measure of cumulative physiological stress calculated from blood pressure, metabolic, immune, and neuroendocrine markers) to overall survival in endometrial cancer. - Among 2,174 patients, 69% had high allostatic load at diagnosis. High allostatic load was associated with a 58% higher adjusted risk of death compared to low allostatic load. The burden was not randomly distributed: high allostatic load was significantly more prevalent among Black patients, those who were not married, and those without private insurance. These findings suggest that physiological stress, including the chronic stress of navigating structural disadvantage, may be a direct contributor to survival differences that cannot be explained by tumor biology alone. ([Read the full paper](https://doi.org/10.1002/cam4.71993)) --- **Liquid biopsy for endometrial cancer: promising, but not yet ready for clinic** "Liquid biopsy" (detecting tumor-derived markers in the blood rather than from a tissue sample) has been intensively researched in endometrial cancer as a potential way to monitor disease, detect recurrence early, and guide treatment decisions without repeat surgery. - A narrative review summarized current evidence on five types of circulating biomarkers: circulating tumor DNA (ctDNA), circulating tumor cells, extracellular vesicles, circulating microRNAs, and tumor-educated platelets. Among these, ctDNA has the strongest evidence base, particularly for monitoring treatment response, detecting residual disease, and identifying early recurrence in high-risk or recurrent disease. However, sensitivity remains limited in early-stage, low-volume tumors. The review concludes that liquid biopsy is a promising complement to, but not a replacement for, tissue-based diagnosis, and that prospective trials demonstrating clinical benefit are still needed. ([Read the full paper](https://doi.org/10.3390/biom16060911)) --- **A remarkable case: fertility preserved, then a healthy pregnancy, after uterine adenosarcoma** For young people diagnosed with uterine adenosarcoma, a rare mixed tumor of the uterus, published case literature on fertility-sparing outcomes is extremely thin. - A case report from Berlin describes a 29-year-old with stage IA uterine adenosarcoma (no sarcomatous overgrowth, no myometrial invasion) who chose fertility-sparing treatment with close surveillance rather than immediate hysterectomy. She spontaneously conceived in 2023 and delivered a healthy infant in 2024; as of 2025, there was no evidence of recurrence. The paper notably includes a first-person patient perspective section describing the emotional experience of diagnosis, the fear of infertility, and the anxiety of pregnancy after cancer. The authors are careful to note that fertility preservation is only appropriate for early-stage adenosarcoma without high-risk features, and that thorough counseling and strict follow-up are essential. This is early-stage, very rare disease; findings cannot be generalized, but the case adds meaningfully to very limited literature. ([Read the full paper](https://doi.org/10.1007/s00404-026-08443-x)) --- **A new serum biomarker for diagnosis? Endocan and HE4 show early signal** Among several studies investigating blood-based diagnostic markers for endometrial cancer, one prospective case-control study stood out for its methodological rigor. - Researchers measured levels of four serum proteins (endocan, HE4, neopterin, and sialyl-Tn) before treatment in 133 patients with endometrial cancer and 65 healthy controls. Endocan and HE4 were significantly elevated in cancer patients, with areas under the curve of 0.758 and 0.702 respectively, which is a modest but potentially useful discrimination. Neopterin and sialyl-Tn showed no significant differences. The authors note that these findings are exploratory and require external validation before clinical application. This is early-phase biomarker research, not ready for clinical testing. ([Read the full paper](https://doi.org/10.1590/1806-9282.20251949)) --- **Endometrial ablation and unexpected cancer: what the pathology looks like** Endometrial ablation (a procedure used to treat heavy menstrual bleeding by destroying the uterine lining) is only approved for people without known malignancy or precancer. But occasionally, cancer or atypical hyperplasia (a precancerous state) is found incidentally on specimens taken during the procedure. - A retrospective single-center analysis described 11 patients (8 with atypical endometrial hyperplasia, 3 with endometrial cancer) who underwent hysterectomy after an incidental diagnosis following endometrial ablation. In 6 of 8 hyperplasia cases, no residual atypia was found in the final surgical specimen; none of the three cancer cases showed residual invasive disease. The study is small and descriptive, but provides clinicopathological reassurance that prior ablation does not appear to compromise oncologic outcomes in this setting. It also reinforces the importance of careful patient selection and thorough diagnostic evaluation before ablation. ([Read the full paper](https://doi.org/10.1007/s00404-026-08497-x)) --- **What Does This Mean for Me?** **Should I ask whether immunotherapy is appropriate as part of my first-line treatment?** If you have advanced or recurrent endometrial cancer, the evidence this month reinforces that adding an immune checkpoint inhibitor to platinum-based chemotherapy extends both progression-free and overall survival, particularly if your tumor has mismatch repair deficiency (dMMR), which your care team can determine through routine testing. If you haven't had your tumor tested for MMR status or MSI (microsatellite instability), ask whether that testing has been done or can be arranged. A question to raise: "Has my tumor been tested for mismatch repair deficiency, and does that affect which first-line treatments I should consider?" **Should I ask about the updated staging system and what it means for my treatment plan?** The 2023 FIGO staging system integrates molecular information that can change a patient's stage and, by extension, their recommended treatment. Compared to the older 2009 system, about 15% of patients are reclassified. If you were diagnosed recently, it's worth asking whether your staging incorporated molecular testing (POLE mutation status, mismatch repair, and p53 status) as recommended by current guidelines. A question to raise: "Was my staging done using the 2023 FIGO criteria, including molecular markers?" **I've experienced discrimination in healthcare settings and feel hesitant about returning for follow-up. Is that common?** You are not alone. June's research confirms that perceived discrimination significantly increases medical mistrust among endometrial cancer survivors, and that this pattern holds across racial, educational, and geographic groups. This is a documented barrier to care, not a personal failing. If you've had difficult experiences in healthcare settings, it may help to speak with a patient navigator, social worker, or cancer support organization that can help you find culturally responsive care. You also have the right to ask your care team directly about accommodations or to bring a trusted advocate to appointments. *This digest is prepared by OCRA (Ovarian Cancer Research Alliance) for patients, caregivers, and advocates. It is intended to inform, not to guide individual treatment decisions. Please speak with your care team about what research findings may mean for your specific situation.* --- **Sources** **Directly Referenced in This Digest** 1. Huang Z, et al. "PD-1/PD-L1 inhibitors plus chemotherapy as first-line therapy for advanced or metastatic endometrial cancer: a systematic review and meta-analysis of randomized controlled trials." *Frontiers in Immunology.* June 1, 2026. PMID 42305528. 2. Soyak B, Ozgul N. "Comparison of spread patterns and survival outcomes in uterine carcinosarcoma versus grade 3 endometrioid endometrial cancer." *Journal of Cancer Research and Clinical Oncology.* June 17, 2026. PMID 42307776. 3. Demirden A, et al. "Validation of the 2023 International Federation of Gynecology and Obstetrics staging system in a large retrospective cohort." *Revista da Associacao Medica Brasileira.* June 29, 2026. PMID 42384971. 4. Jang EB, Shim SH, Park JY. "Sentinel Lymph Node Mapping Versus Systemic Lymphadenectomy in High-Risk Endometrial Cancer Patients: A Meta-Analysis of Oncologic Outcomes." *Journal of Minimally Invasive Gynecology.* January 13, 2026. PMID 41539500. *(Note: electronic publication date January 2026; indexed in June 2026 issue)* 5. Kaban A, et al. "Defining low-risk group before surgical treatment in endometrial cancer: A retrospective review." *Medicine.* June 19, 2026. PMID 42332487. 6. Han KH, et al. "Risk-Based Survival Outcomes in Early-Stage Endometrial Cancer: Impact of Radiation Therapy." *Journal of Korean Medical Science.* June 15, 2026. PMID 42299140. 7. Muñoz-Casares FC, et al. "Surgical Management and Therapeutic Strategy of Uterine Sarcoma According to Histological Subtype and Staging: Updated Review and Recommendations." *Cancers.* June 8, 2026. PMID 42352405. 8. Kilic Bagir E, et al. "Prognostic Implications of Combined p53 and Mismatch-Repair Immunophenotypes in Uterine Carcinosarcoma." *Medicina.* June 10, 2026. PMID 42356147. 9. Rajendran R, et al. "Screening for endometrial hyperplasia and endometrial cancer in premenopausal women with PCOS: a systematic review protocol." *BMJ Open.* June 30, 2026. PMID 42379723. 10. Katayama K, et al. "Impact of Sarcopenia and Pretreatment Skeletal Muscle Loss on Survival in Endometrial Cancer Patients Treated With Immune Checkpoint Inhibitors." *Journal of Obstetrics and Gynaecology Research.* June 2026. PMID 42264544. 11. Wang H, et al. "Endometrial Cancer of the Uterine Isthmus: A Cohort Study on Clinicopathological Features and Prognosis." *Cancer Medicine.* June 2026. PMID 42310273. 12. Brown JA, et al. "Perceived Discrimination and Healthcare System Trust as Barriers to Survivorship Care in Endometrial Cancer." *Cancer Medicine.* June 2026. PMID 42321601. 13. Sinha N, et al. "Impact of Allostatic Load on Overall Survival in Patients With Endometrial Cancer." *Cancer Medicine.* June 2026. PMID 42210577. 14. Giordano WG, et al. "Liquid Biopsy Biomarkers in Endometrial Cancer: Current Landscape and Future Perspectives." *Biomolecules.* June 19, 2026. PMID 42352377. 15. Ziegler E, et al. "Fertility-sparing strategy in a rare case of uterine adenosarcoma and consecutive spontaneous pregnancy and livebirth." *Archives of Gynecology and Obstetrics.* June 23, 2026. PMID 42334466. 16. Toyran A, et al. "Serum human epididymis protein 4, endocan, sialyl-Tn, and neopterin in endometrial cancer: a prospective case-control study." *Revista da Associacao Medica Brasileira.* June 15, 2026. PMID 42307299. 17. Schleicher OM, et al. "Histological evaluation of hysterectomy specimens after NovaSure endometrial ablation in patients with atypical endometrial hyperplasia or endometrial carcinoma." *Archives of Gynecology and Obstetrics.* June 18, 2026. PMID 42315802. --- **Additional Open-Access Papers Published in June 2026 on Related Topics** 18. Chen W, et al. "Research progress of ferroptosis in gynecological diseases." *Annals of Medicine.* June 19, 2026. PMID 42318797. *(Review of ferroptosis — a form of iron-dependent cell death — as a potential therapeutic mechanism in endometrial cancer and other gynecologic malignancies.)* 19. Mondal O, et al. "Integrating artificial intelligence and multi-omics data for precision oncology in endometrial cancer: a narrative review." *Functional & Integrative Genomics.* June 29, 2026. PMID 42366266. *(Comprehensive review of AI-driven multi-omics approaches for subtyping, prognosis, and treatment selection in endometrial cancer.)* 20. Gacuta E, et al. "Diagnostic Potential of Selected Matrilysins and Stromelysins in the Diagnosis of Gynecological Malignancies Based on ROC Curve Analysis." *International Journal of Molecular Sciences.* June 20, 2026. PMID 42353305. *(Exploratory study of matrix metalloproteinase MMP-7 and MMP-10 as potential diagnostic markers in endometrial and cervical cancers, outperforming standard CA125 in some comparisons.)* 21. Akay K, et al. "Platelet-to-Lymphocyte Ratio as a Predictor of Lymphovascular Space Invasion in Endometrioid Endometrial Cancer: Development and Internal Validation of a Continuous Parameter-Based Nomogram." *Medicina.* June 19, 2026. PMID 42356202. *(Retrospective study developing a nomogram using the platelet-to-lymphocyte ratio, tumor size, and age to predict lymphovascular space invasion; findings are exploratory and require external validation.)* 22. Nahar S, et al. "Co-mutations of CTNNB1 and PTEN drive aggressive tumor progression in endometrial cancer." *Disease Models & Mechanisms.* June 18, 2026. PMID 42312452. *(Preclinical mouse model study demonstrating that simultaneous PTEN and beta-catenin/CTNNB1 mutations cause early invasive disease, providing mechanistic insight into an aggressive endometrial cancer subtype.)* 23. Kang SW, et al. "Dual PARP/Tankyrase Inhibition Enhances Antitumor Efficacy in PTEN-Deficient Endometrial Cancer." *Journal of Cellular and Molecular Medicine.* June 2026. PMID 42286682. *(Preclinical study showing that combining a PARP inhibitor with a tankyrase inhibitor has enhanced activity in PTEN-deficient endometrial cancer cells and models, suggesting a potential future combination strategy.)* 24. Zhang Y, et al. "Overexpression of a subset of long intergenic noncoding RNAs in uterine serous carcinoma predicts poor prognosis." *Medicine (Baltimore).* June 26, 2026. PMID 42363453. *(Bioinformatics and tissue validation study identifying specific long noncoding RNA molecules as potential prognostic biomarkers in uterine serous carcinoma, a high-risk subtype.)* 25. Rifaldi F, et al. "Pembrolizumab-Induced Myositis: Diagnostic and Therapeutic Challenges From Two Case Reports and a Narrative Review." *Cancer Reports.* June 2026. PMID 42338361. *(Two case reports including one endometrial cancer patient, plus literature review, on immune-related myositis as a rare but serious adverse event of pembrolizumab; corticosteroid treatment was effective.)* 26. Pu L, et al. "Identification of AC025811.3 and AC012354.6 as two critical survival-related lncRNAs for uterine corpus cancer." *PLoS One.* June 12, 2026. PMID 42284313. *(Multi-cohort bioinformatics analysis identifying two long noncoding RNAs as potential prognostic biomarkers in endometrial carcinoma, with links to immune regulation pathways; requires experimental validation.)* **Papers Excluded Due to Licensing Restrictions** 27. La Torre F, et al. "Elevated ESR2 and BRCA1 gene expression in adenomyosis associated with endometrial cancer: a pilot study." *Gynecological Endocrinology.* June 22, 2026. PMID 42329179. *(Excluded: License not confirmed, subscription journal. Topic: Pilot study of estrogen receptor pathway gene expression in adenomyosis coexisting with endometrial cancer.)* 28. Lin PH, et al. "Frontline immunotherapy and immune cold reprogramming across molecular subtypes of advanced endometrial cancer." *Cancer Letters.* June 4, 2026. PMID 42241805. *(Excluded: All rights reserved, proprietary license. Topic: Comprehensive review of frontline immune checkpoint inhibitor strategies across molecular subtypes, including dMMR, pMMR, and POLE-mutated disease.)* 29. Avesani G, et al. "Pelvic MRI in Endometrial Cancer Staging: A Retrospective Evaluation of the Impact of FIGO 2023." *Radiology.* June 2026. PMID 42377124. *(Excluded: Subscription journal, no open-access license confirmed. Topic: Dual-center study showing that the FIGO 2023 staging update reduces staging concordance between MRI and surgical pathology, particularly due to missed minimal myometrial invasion and micrometastatic lymph nodes.)* 30. He P, et al. "Diagnostic Accuracy and Concordance of Self-Collected Cervical CDO1 and CELF4 Methylation Testing Compared With Physician Sampling for Endometrial Cancer Detection." *JCO Precision Oncology.* June 18, 2026. PMID 42314091. *(Excluded: Hybrid journal, no open-access license confirmed. Topic: Prospective study demonstrating that self-collected vaginal swabs using a DNA methylation assay show diagnostic accuracy equivalent to physician-collected samples for endometrial cancer detection.)* 31. Jiang M, et al. "HJURP upregulation, driven by transcription factor NFYA, promotes endometrial carcinoma progression via regulating RASSF8 ubiquitination." *Functional & Integrative Genomics.* June 20, 2026. PMID 42321518. *(Excluded: Exclusive proprietary Springer license (not open access). Topic: Mechanistic study identifying HJURP as an oncogenic ubiquitin ligase activated by NFYA transcription factor in endometrial carcinoma.)* 32. Blee S, et al. "Understanding mortality trends in patients with uterine malignancies from 1999 to 2023 utilizing the CDC WONDER database." *Journal of Gynecologic Oncology.* June 16, 2026. PMID 42363577. *(Excluded: License not confirmed, subscription journal. Topic: Analysis of 262,431 uterine cancer deaths in the US 1999–2023 showing rising overall mortality, with Black/African American patients consistently experiencing the highest age-adjusted mortality rates.)* 33. Odintsov I, et al. "Clinicopathologic Study of 39 Mismatch Repair-deficient Sarcomas Demonstrates Recurrent Histologic Patterns and Supports Universal Screening of Pleomorphic Rhabdomyosarcoma, Uterine Leiomyosarcoma, and Undifferentiated and Unclassified Sarcomas." *The American Journal of Surgical Pathology.* June 12, 2026. PMID 42281350. *(Excluded: All rights reserved, proprietary license. Topic: Characterization of dMMR sarcomas including uterine leiomyosarcoma (5.6% prevalence), proposing universal MMR screening for uterine LMS, pleomorphic rhabdomyosarcoma, and undifferentiated sarcomas, with evidence for benefit from immune checkpoint inhibition.)* 34. Kihara A. "Undifferentiated Carcinoma of the Endometrium: Morphology, Immunophenotype, and Differential Diagnoses to Avoid Diagnostic Pitfalls." *Pathology International.* June 2026. PMID 42332371. *(Excluded: License not confirmed. Topic: Review of undifferentiated endometrial carcinoma histology and immunophenotype to aid in distinguishing it from other uterine tumors.)*

The Month in Uterine Cancer Research

Published