Endometrial cancer (EC) is a significant health concern in France, necessitating high-quality surgical care to improve patient outcomes. The European Society of Gynaecological Oncology (ESGO) established quality indicators (QIs) to standardize and improve management.

This study evaluates the applicability of ESGO QIs in a real-world setting across 13 centers in France.

This retrospective multicenter cohort study included 2,789 patients surgically treated for EC from 2001 to 2020. Demographic data, surgical techniques, adherence to ESGO QIs and trends over time were analyzed. Key indicators analyzed included multidisciplinary team discussions, pre-operative imaging adequacy, surgical techniques employed, and molecular classifications.

All patients were discussed in multidisciplinary meetings. Adequate preoperative imaging was achieved in 80.63% of cases. Minimally invasive surgery was performed in 66.12% of early-stage patients, showing a significant year-on-year increase from 12% in 2001 to 85% in 2020. Among obese patients, 60.78% underwent laparoscopic procedures, with a conversion rate to open surgery of 3.57%. Molecular classification results highlighted 35% of patients as low risk and 32% as high risk.

Our findings indicate that adherence to actual ESGO QIs has substantially improved the quality of surgical management for endometrial cancer in France, despite some areas requiring further enhancement. A coordinated political approach is essential to address existing barriers and ensure consistent implementation of these quality standards across all centers, ultimately aiming to elevate patient care and outcomes in the French healthcare system.