Relevance of Molecular Profiling in Patients With Low-Grade Endometrial Cancer

Result code in IS VaVaI

<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F65269705%3A_____%2F22%3A00077825" target="_blank" >RIV/65269705:_____/22:00077825 - isvavai.cz</a>

Alternative codes found

RIV/00216224:14110/22:00127562

Result on the web

<a href="https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2799631" target="_blank" >https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2799631</a>

DOI - Digital Object Identifier

<a href="http://dx.doi.org/10.1001/jamanetworkopen.2022.47372" target="_blank" >10.1001/jamanetworkopen.2022.47372</a>

Result language

angličtina

Original language name

Relevance of Molecular Profiling in Patients With Low-Grade Endometrial Cancer

Original language description

IMPORTANCE Patients with low-grade (ie, grade 1-2) endometrial cancer (EC) are characterized by their favorable prognosis compared with patients with high-grade (ie, grade 3) EC. With the implementation of molecular profiling, the prognostic relevance of tumor grading might lose attention. As most patients present with low-grade EC and have an excellent outcome, the value of molecular profiling for these patients is unclear. OBJECTIVE To determine the association of molecular profiling with outcomes among patients with low-grade EC. DESIGN, SETTING, AND PARTICIPANTS This retrospective cohort study included a multicenter international European cohort of patients diagnosed with EC between 1994 and 2018, with a median follow-up of 5.9 years. Molecular subgroups were determined by next-generation sequencing using single-molecule molecular inversion probes and by immunohistochemistry. Subsequently, tumors were classified as polymerase epsilon (POLE)-altered, microsatellite instable (MSI), tumor protein p53 (TP53)-altered, or no specific molecular profile (NSMP). Patients diagnosed with any histological subtypes and FIGO (International Federation of Gynecology and Obstetrics) stages of EC were included, but patients with early-stage EC (FIGO I-II) were only included if they had known lymph node status. Data were analyzed February 20 to June 16, 2022. EXPOSURES Molecular testing of the 4 molecular subgroups. MAIN OUTCOMES AND MEASURES The main outcome was disease-specific survival (DSS) within the molecular subgroups. RESULTS A total of 393 patients with EC were included, with a median (range) age of 64.0 (31.0-86.0) years and median (range) body mass index (BMI; calculated as weight in kilograms divided by height in meters squared) of 29.1 (18.0-58.3). Most patients presented with early-stage (290 patients [73.8%]) and low-grade (209 patients [53.2%]) disease. Of all patients, 33 (8.4%) had POLE-altered EC, 78 (19.8%) had MSI EC, 72 (18.3%) had TP53-altered EC, and 210 (53.4%) had NSMP EC. Across all molecular subgroups, patients with low-grade EC had superior 5-year DSS compared with those with high-grade EC, varying between 90% to 100% vs 41% to 90% (P &lt;.001). Multivariable analysis in the entire cohort including age, tumor grade, FIGO stage, lymphovascular space invasion, and the molecular subgroups as covariates found that only high-grade (hazard ratio [HR], 4.29; 95% CI, 2.15-8.53; P &lt;.001), TP53-altered (HR, 1.76; 95% CI, 1.04-2.95; P =.03), and FIGO stage III or IV (HR, 4.26; 95% CI, 2.50-7.26; P &lt;.001) disease were independently associated with reduced DSS. CONCLUSIONS AND RELEVANCE This cohort study found that patients with low-grade EC had an excellent prognosis independent of molecular subgroup. These findings do not support routine molecular profiling in patients with low-grade EC, and they demonstrate the importance of primary diagnostic tumor grading and selective profiling in low-grade EC to increase cost-effectiveness.

Czech name

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Czech description

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Type

J_imp - Article in a specialist periodical, which is included in the Web of Science database

CEP classification

—

OECD FORD branch

30200 - Clinical medicine

Project

—

Continuities

I - Institucionalni podpora na dlouhodoby koncepcni rozvoj vyzkumne organizace

Publication year

2022

Confidentiality

S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů

Name of the periodical

JAMA NETWORK OPEN

ISSN

2574-3805

e-ISSN

2574-3805

Volume of the periodical

5

Issue of the periodical within the volume

12

Country of publishing house

US - UNITED STATES

Number of pages

10

Pages from-to

nestrankovano

UT code for WoS article

000919589300010

EID of the result in the Scopus database

2-s2.0-85144589126