Clinical factors as prognostic variables among molecular subgroups of endometrial cancer

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Kolehmainen , A , Pasanen , A , Tuomi , T , Koivisto-Korander , R , Bützow , R & Loukovaara , M 2020 , ' Clinical factors as prognostic variables among molecular subgroups of endometrial cancer ' , PLoS One , vol. 15 , no. 11 , 0242733 . https://doi.org/10.1371/journal.pone.0242733

Title: Clinical factors as prognostic variables among molecular subgroups of endometrial cancer
Author: Kolehmainen, Anne; Pasanen, Annukka; Tuomi, Taru; Koivisto-Korander, Riitta; Bützow, Ralf; Loukovaara, Mikko
Contributor: University of Helsinki, Department of Obstetrics and Gynecology
University of Helsinki, HUSLAB
University of Helsinki, HUS Gynecology and Obstetrics
University of Helsinki, HUS Gynecology and Obstetrics
University of Helsinki, HUSLAB
University of Helsinki, HUS Gynecology and Obstetrics
Date: 2020-11-24
Language: eng
Number of pages: 12
Belongs to series: PLoS One
ISSN: 1932-6203
URI: http://hdl.handle.net/10138/324360
Abstract: Background Clinical factors may influence endometrial cancer survival outcomes. We examined the prognostic significance of age, body mass index (BMI), and type 2 diabetes among molecular subgroups of endometrial cancer. Methods This was a single institution retrospective study of patients who underwent surgery for endometrial carcinoma between January 2007 and December 2012. Tumors were classified into four molecular subgroups by immunohistochemistry of mismatch repair (MMR) proteins and p53, and sequencing of polymerase-epsilon (POLE). Overall, cancer-related, and non-cancer-related mortality were estimated using univariable and multivariable survival analyses. Results Age >65 years was associated with increased mortality rates in the whole cohort (n = 515) and in the "no specific molecular profile" (NSMP) (n = 218) and MMR deficient (MMR-D) (n = 191) subgroups during a median follow-up time of 81 months (range 1-136). However, hazard ratios for cancer-related mortality were non-significant for NSMP and MMR-D. Diabetes was associated with increased overall and non-cancer-related mortality in the whole cohort and MMR-D subgroup. Overweight/obesity had no effect on outcomes in the whole cohort, but was associated with decreased overall and cancer-related mortality in the NSMP subgroup, and increased overall and non-cancer-related mortality in the MMR-D subgroup. Overweight/obesity effect on cancer-related mortality in the NSMP subgroup remained unchanged after controlling for confounders. High-risk uterine factors were more common, and estrogen and progesterone receptor expression less common in NSMP subtype cancers of normal-weight patients compared with overweight/obese patients. No clinical factors were associated with outcomes in p53 aberrant (n = 69) and POLE mutant (n = 37) subgroups. No cancer-related deaths occurred in the POLE mutant subgroup. Conclusions The prognostic effects of age, BMI, and type 2 diabetes do not appear to be uniform for the molecular subgroups of endometrial cancer. Our data support further evaluation of BMI combined with genomics-based risk-assessment.
Subject: CELL-ADHESION MOLECULE
BODY-MASS INDEX
DIABETES-MELLITUS
SURVIVAL
EXPRESSION
MORTALITY
PREDICTOR
PATTERNS
DISEASE
CARCINOMA
3123 Gynaecology and paediatrics
3111 Biomedicine
3122 Cancers
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