Pölcher M, et al. - Via a population-based study of 5,546 endometrial cancer patients, researchers intended to review the implementation of lymph node dissection (LND), a risk-adapted strategy. No significant difference could be found in the time to local recurrence, lymph node recurrence, or distant metastases among patients with and without LND, even when adjusted for age and comorbidity-status. Thus, in early endometrial cancer in real-life, the application of risk-adapted management of LND was linked to a high rate of surgical under- and overtreatment. A significant advantage of a systematic lymph node dissection couldn't be exhibited through corresponding survival data. Hence, prospective trials, new surgical concepts, and prognostic markers are essential for the improvement of the management and results of early endometrial cancer in the future.