Clinicopathologic vs. Molecular Integrated Prognostication of Endometrial Carcinoma by European Guidelines

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http://hdl.handle.net/10138/340157

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Loukovaara, M.; Pasanen, A.; Bützow, R. Clinicopathologic vs. Molecular Integrated Prognostication of Endometrial Carcinoma by European Guidelines. Cancers 2022, 14, 651.

Title: Clinicopathologic vs. Molecular Integrated Prognostication of Endometrial Carcinoma by European Guidelines
Author: Loukovaara, Mikko; Pasanen, Annukka; Bützow, Ralf
Publisher: Multidisciplinary Digital Publishing Institute
Date: 2022-01-27
URI: http://hdl.handle.net/10138/340157
Abstract: This was a retrospective study of 604 patients with endometrial carcinoma, classified into ESGO-ESTRO-ESP 2021 clinicopathologic and molecular integrated risk groups. The Proactive Molecular Risk Classifier for Endometrial Cancer (ProMisE) and Leiden classifier were employed for molecular classification. Median follow-up time was 81 months. Clinicopathologic and molecular integrated risk groups were similarly associated with distinct prognoses (<i>p</i> &lt; 0.001). Disease-specific survival was similar for all molecular subgroups within clinicopathologic intermediate-risk, high-risk, and advanced/metastatic groups. In contrast, the p53 abnormal subgroup (hazard ratio 9.1, 95% confidence interval 2.0&ndash;41; <i>p</i> = 0.004) and mismatch repair deficient subgroup (hazard ratio 3.5, 95% confidence interval 1.2&ndash;10; <i>p</i> = 0.024) were associated with disease-related death within clinicopathologic low-risk and high-intermediate-risk carcinomas, respectively. A risk-group shift occurred in 6.0% (36/604) and 7.4% (38/515) of patients classified by ProMisE and Leiden, respectively (<i>p</i> = 0.341). Of the 36 patients shifted in the ProMisE cohort, 27 were upshifted and 9 downshifted. Based on the Leiden classifier, polymerase-&#1013; sequencing could be omitted in 60% (311/515) of patients without affecting the risk-group assessment. ESGO-ESTRO-ESP 2021 guidelines provide a platform for risk classification in future trials on molecularly directed treatment of endometrial carcinoma.


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