Wortman BG, et al. - The Post-Operative Radiation Therapy in Endometrial Carcinoma (PORTEC)-4a trial was the first randomized trial to assess adjuvant treatment based on the molecular-integrated risk profile in women with high-intermediate risk endometrial cancer (EC), vs standard vaginal brachytherapy (VBT). Analysis of the pathology database demonstrated the average time between randomization and determination of the molecular-integrated risk profile was 10.2 days (1–23 days). According to the findings obtained, the PORTEC-4a trial design was proven feasible with a satisfactory patient acceptance rate and an optimized workflow of the determination of the molecular-integrated risk profile.