Endometrial cancer is the most common gynecologic cancer in high-income countries, affecting more than 417,000 women worldwide each year (Sung et al., CA Cancer J Clin, 2021). Survival has steadily improved, largely because most patients are diagnosed at an early stage when the disease is confined to the uterus and highly curable. Understanding the endometrial cancer remission rate—how often the disease disappears completely after treatment—helps patients interpret what to expect and why outcomes vary widely between stages and tumor types.
Remission is achieved when no detectable cancer remains after treatment. Many women, especially those with Stage I disease, experience long-lasting remission and may be considered “cured” if the cancer does not return within several years. But remission rates differ significantly based on stage, histology, molecular profile, treatment approach, and patient factors such as age and comorbidities.
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How Doctors Measure the Endometrial Cancer Remission Rate
The endometrial cancer remission rate is traditionally assessed based on:
- Complete response (CR) after treatment, meaning no clinical or radiographic evidence of cancer.
- Recurrence-free survival (RFS), which shows how many women remain cancer-free at key time points.
- Overall survival (OS), which indirectly reflects remission durability.
These metrics come from large cancer registries (SEER, NCI), clinical trials, and international guideline groups (NCCN, ESGO/ESTRO/ESP). Because remission is stage-dependent, the most important determinant of outcome is how early the cancer is found.
Endometrial Cancer Remission Rate by Stage
Stage I: The Highest Chance of Remission: Approximately 70–75% of cases are diagnosed at Stage I. Surgery alone leads to remission in the vast majority of patients. According to SEER 2024 and ACS statistics, the endometrial cancer remission rate in Stage I is between 85% and 95%, depending on tumor grade and depth of invasion. Five-year survival mirrors remission probability: 95% for Stage IA and 88% for Stage IB. Most recurrences happen within three years, but after five recurrence-free years, the risk becomes very low.
These excellent outcomes explain why early diagnosis—often triggered by postmenopausal bleeding—is the key reason endometrial cancer has one of the highest remission rates among gynecologic cancers.
Stage II: Still High Remission but More Complex Treatment: Stage II disease extends into the cervical stroma. Remission remains achievable with combined surgery and radiation. Studies such as the PORTEC-3 trial (Lancet Oncol 2018) show that adjuvant chemoradiation improves local control and reduces recurrence risk.
Remission rates range from 75% to 85%, depending on grade and lymphovascular space invasion (LVSI). Five-year survival for Stage II averages 70–80%, supporting the strong remission potential when multimodality therapy is used.
Stage III: Regional Spread Lowers Remission Potential: Stage III disease includes lymph-node involvement or local extension. The remission rate declines, but a substantial proportion still benefit from aggressive therapy.
Data from PORTEC-3 and GOG-258 show that:
- Combined chemoradiation leads to the longest recurrence-free survival in high-risk Stage III patients.
- Surgery + chemotherapy also provides durable control in many women.
Across large population datasets, the endometrial cancer remission rate in Stage III is 50–65%, while five-year survival is 55–65%. Recurrence commonly occurs in pelvic or para-aortic lymph nodes or distant sites such as the lungs.
Stage IV: Low Remission Rates, but Immunotherapy Is Changing Outcomes: Stage IV disease involves distant metastases. Historically, remission rates were poor, around 15–20% with chemotherapy alone. SEER reports a five-year survival of roughly 17%.
However, dMMR/MSI-H endometrial cancers respond exceptionally well to immune checkpoint inhibitors. KEYNOTE-158 (JCO 2019) and the GARNET trial (JCO 2022) report:
- Pembrolizumab response rate ~48%
- Dostarlimab response rate ~45%
Many responses are long-lasting, with durable remissions exceeding two years.
For this molecular subgroup, the endometrial cancer remission rate is now significantly higher than historical expectations, marking a major shift in Stage IV management.
How Tumor Type Influences the Endometrial Cancer Remission Rate
Endometrial cancer includes multiple histologic subtypes with different behaviors and remission probabilities.
Endometrioid carcinoma (Type I): The most common form. Usually low-grade and estrogen-dependent. Five-year survival often exceeds 90% in early stages. Remission rates are highest in this group.
Serous carcinoma, clear cell carcinoma, carcinosarcoma (Type II): These aggressive histologies carry lower remission rates due to earlier spread and higher recurrence risk. PORTEC and GOG trials show recurrence rates up to 40–50% even in Stage I–II disease.
TCGA Molecular Subtypes
Modern classification divides tumors into:
- POLE-ultramutated: Extremely high remission rates, recurrence <3%.
- MSI-H/dMMR: High immunotherapy responsiveness.
- Copy-number low (NSMP): Intermediate remission rates.
- Copy-number high (p53-mutant): Lowest remission and highest relapse risk.
These molecular categories increasingly guide prognosis and adjuvant therapy decisions, improving remission outcomes through treatment personalization.
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How Modern Treatments Improve Remission
Surgery: Total hysterectomy with bilateral salpingo-oophorectomy is the cornerstone of curative therapy. Most Stage I patients require no additional treatment to achieve remission.
Radiation Therapy: Reduces local recurrence risk. PORTEC-2 demonstrated that vaginal brachytherapy reduces recurrence to below 5% in selected patients.
Chemotherapy: Essential for high-grade, serous, or Stage III–IV disease. GOG-258 found that chemotherapy lowers distant recurrence risk, improving long-term remission.
Immunotherapy: A major breakthrough for MSI-H/dMMR tumors. Responses seen with pembrolizumab and dostarlimab are significantly more durable than those from chemotherapy alone.
Hormonal Therapy: Used in fertility-preserving treatment or for low-grade recurrent disease. Complete remission rates of 70–80% are reported with high-dose progestins.
Recurrence After Achieving Remission
Even after remission, recurrence remains possible. Rates vary by stage:
- Stage I: 10–15%
- Stage II: 15–20%
- Stage III: 30–40%
- Stage IV: Over 50%
Most recurrences occur within three years, emphasizing the importance of early follow-up visits and symptom monitoring.
Long-Term Outlook and Survivorship
Many women live for decades after successful treatment. Survivorship care focuses on:
- Early detection of recurrence
- Management of treatment side effects
- Cardiovascular health
- Bone health
- Emotional well-being
Thanks to earlier diagnosis, molecular testing, and expanding immunotherapy options, the endometrial cancer remission rate is improving across nearly all patient groups.
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Written by Armen Gevorgyan, MD