Endometrial Cancer 5-Year Overall Survival by Stage
Five-year overall survival rates for endometrial cancer demonstrate excellent outcomes for early-stage disease (Stage I: 87-97.5%) with progressively worse survival as stage advances (Stage II: 79-87.5%, Stage III: 76-85%, Stage IV: 12.5-15%).
Stage-Specific Survival Rates
Stage I Disease
- 5-year overall survival: 87.1-97.5% 1, 2
- The most recent validation study from 2026 using the updated FIGO 2023 staging system reported 5-year OS of 87.1% for Stage I 2
- Earlier data showed even higher rates of 97.5% 1
- Stage IA specifically: Historical data shows 92% 5-year survival with surgery alone 3
- Stage IB: 93-94% 5-year survival, with one study showing 94.4% relapse-free survival 4
Stage II Disease
- 5-year overall survival: 79.2-87.5% 1, 2
- The 2026 validation study demonstrated improved discrimination with FIGO 2023, showing 79.2% 5-year OS 2
- Earlier cohorts reported 87.5% 1
Stage III Disease
- 5-year overall survival: 52.3-85.2% 1, 2
- Combined Stage III-IV data from 2026 shows 52.3% 5-year OS 2
- Stage IIIC specifically: Notably better outcomes at 76.5% 5-year survival when treated with extensive surgery and adjuvant chemotherapy 1
- The PORTEC-3 trial demonstrated 5-year OS of 81.4% with combined chemoradiotherapy versus 76.1% with radiotherapy alone in high-risk Stage III patients 5
Stage IV Disease
- 5-year overall survival: 12.5-15% 1, 6
- Actuarial 5-year survival of 15% (95% CI: 3-36%) 6
- Median survival approximately 12 months from diagnosis 6
- Durable responses can occasionally be achieved in select patients 6
Impact of Histologic Grade on Survival
Grade significantly impacts survival within each stage:
Stage I by Grade
- Grade 1: 96% 5-year survival 3
- Grade 2: 90% 5-year survival 3
- Grade 3: 80% 5-year survival 3
- Survival decreases significantly with increased tumor dedifferentiation 3
Unfavorable Histologic Types
- Poorly differentiated endometrioid adenocarcinoma: 50.8% 5-year OS, 41.9% recurrence-free survival 7
- Stage I with unfavorable histology (clear-cell, serous papillary, poorly differentiated, mixed): Overall 5-year survival 60.1%, recurrence-free survival 52.1% 7
Key Prognostic Factors Beyond Stage and Grade
The most recent large cohort analysis from 2026 identified independent predictors of overall survival 8:
- FIGO stage (most significant)
- Nodal status (nodal metastasis present in 5.8% overall) 8
- Age (median 56 years; ≥60 years associated with worse outcomes) 8
- BMI (mean 32.8 kg/m²; obesity prevalent) 8
- Deep myometrial invasion (≥50% present in 47.7%) 8
Clinical Context and Caveats
Important considerations:
- The 2025 ESGO guidelines now incorporate molecular classification, which enables more precise risk stratification beyond traditional staging 9, 10
- Recent data shows that molecular classification reclassifies approximately 10% of patients to different risk groups, impacting treatment decisions 10
- Overall 5-year survival across all stages in contemporary cohorts is approximately 88.6% (95% CI: 85.6-91.7%), reflecting the predominance of early-stage disease at diagnosis 8
- Approximately 71% of patients present with Stage I disease 8
- Recurrence rates remain significant even in early-stage disease: approximately 52% of advanced-stage patients experience recurrence despite treatment 5
Treatment impact on survival:
- Stage III patients benefit most from combined modality therapy (chemotherapy plus radiation) 5
- Stage IIIC patients treated with extensive surgery plus chemotherapy show markedly better outcomes (76.5% 5-year survival) compared to historical controls 1
- Stage IV disease has poor prognosis regardless of treatment approach, though occasional durable responses occur 6