The disease at the Clinic

The Gynaecological Oncology Unit at Hospital Clínic Barcelona diagnoses and treats more than 150 women with endometrial cancer each year, making it one of the most experienced hospitals in the treatment of this disease.

The hospital has pioneered minimally invasive surgery, even in complex cases. Currently, over 95% of patients undergo laparoscopy or robotic surgery, which allows for faster recovery, fewer complications, and shorter hospital stays. The Clínic has a team with extensive experience in robotic gynaecological surgery.

The existence of a Clinical Trials Unit allows patients to take part in national and international multicentre trials, giving them access to new treatments currently under investigation, both after surgery and in cases of advanced or recurrent disease. In addition, the hospital routinely carries out molecular tumour profiling, which enables treatment to be personalised and helps avoid unnecessary treatments when they are unlikely to be beneficial.

Furthermore, the Clínic has extensive experience in gynaecological brachytherapy, a highly precise form of radiotherapy carried out in specialist centres, which improves disease control whilst reducing side effects.

Fertility‑preserving treatment for endometrial cancer and its precursor lesions in young women

Endometrial cancer and its precursor condition, atypical endometrial hyperplasia, can be diagnosed in young women who have not yet conceived. In carefully selected cases, it may be possible to offer a conservative treatment that preserves the uterus, avoiding immediate surgery. This treatment is mainly indicated for low-grade endometrioid tumours confined to the endometrium, following a comprehensive assessment that includes imaging tests and molecular analysis. This strategy should be carried out in specialist centres with the relevant experience and within the framework of a multidisciplinary team.

Conservative treatment usually involves hormonal therapy with progestogens, administered via a levonorgestrel-releasing intrauterine device, oral medication, or a combination of both. Complete remission can be achieved in approximately 70–80% of selected patients with this treatment. Close monitoring during treatment is essential. This includes regular biopsies—typically every 3–6 months—to assess response to treatment and to detect any persistence or progression of the disease at an early stage.

Once complete remission has been achieved, patients are encouraged to pursue pregnancy as soon as possible, often with the support of assisted reproductive technologies. Once the patient has made a decision regarding future pregnancy, doctors recommend definitive surgery to remove the uterus, as there is a 30–40% risk of recurrence.

Our centre serves as a national referral hospital for conservative management of endometrial cancer. It has extensive experience in patient follow‑up and works in close collaboration with assisted reproduction units to provide the best options for fertility preservation while ensuring oncological safety.