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Immunohistochemical biomarkers are prognostic relevant in addition to the ESMO-ESGO-ESTRO risk classification in endometrial cancer
SW. Vrede, WJ. van Weelden, NCM. Visser, J. Bulten, LJM. van der Putten, K. van de Vijver, M. Santacana, E. Colas, A. Gil-Moreno, CP. Moiola, G. Mancebo, C. Krakstad, J. Trovik, IS. Haldorsen, J. Huvila, M. Koskas, V. Weinberger, M. Bednarikova,...
Language English Country United States
Document type Journal Article, Multicenter Study
- MeSH
- Survival Analysis MeSH
- Cohort Studies MeSH
- Humans MeSH
- Lymphatic Metastasis MeSH
- Neural Cell Adhesion Molecule L1 metabolism MeSH
- Biomarkers, Tumor metabolism MeSH
- Endometrial Neoplasms diagnosis mortality pathology MeSH
- Predictive Value of Tests MeSH
- Prognosis MeSH
- Retrospective Studies MeSH
- Risk Factors MeSH
- Aged MeSH
- Check Tag
- Humans MeSH
- Aged MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Multicenter Study MeSH
- Geographicals
- Europe MeSH
OBJECTIVE: Pre-operative immunohistochemical (IHC) biomarkers are not incorporated in endometrial cancer (EC) risk classification. We aim to investigate the added prognostic relevance of IHC biomarkers to the ESMO-ESGO-ESTRO risk classification and lymph node (LN) status in EC. METHODS: Retrospective multicenter study within the European Network for Individualized Treatment of Endometrial Cancer (ENITEC), analyzing pre-operative IHC expression of p53, L1 cell-adhesion molecule (L1CAM), estrogen receptor (ER) and progesterone receptor (PR), and relate to ESMO-ESGO-ESTRO risk groups, LN status and outcome. RESULTS: A total of 763 EC patients were included with a median follow-up of 5.5-years. Abnormal IHC expression was present for p53 in 112 (14.7%), L1CAM in 79 (10.4%), ER- in 76 (10.0%), and PR- in 138 (18.1%) patients. Abnormal expression of p53/L1CAM/ER/PR was significantly related with higher risk classification groups, and combined associated with the worst outcome within the 'high and advanced/metastatic' risk group. In multivariate analysis p53-abn, ER/PR- and ESMO-ESGO-ESTRO 'high and advanced/metastatic' were independently associated with reduced disease-specific survival (DSS). Patients with abnormal IHC expression and lymph node metastasis (LNM) had the worst outcome. Patients with LNM and normal IHC expression had comparable outcome with patients without LNM and abnormal IHC expression. CONCLUSION: The use of pre-operative IHC biomarkers has important prognostic relevance in addition to the ESMO-ESGO-ESTRO risk classification and in addition to LN status. For daily clinical practice, p53/L1CAM/ER/PR expression could serve as indicator for surgical staging and refine selective adjuvant treatment by incorporation into the ESMO-ESGO-ESTRO risk classification.
Centre for Cancer Biomarkers Department of Clinical Science University of Bergen Bergen Norway
Department of Obstetrics and Gynaecology Canisius Wilhelmina Hospital Nijmegen the Netherlands
Department of Obstetrics and Gynaecology Department Bichat Claude Bernard Hospital Paris France
Department of Obstetrics and Gynaecology Haukeland University Hospital Bergen Norway
Department of Obstetrics and Gynaecology Hospital del Mar PSMAR Barcelona Spain
Department of Obstetrics and Gynaecology Radboud university medical center Nijmegen the Netherlands
Department of Oncology KU Leuven Leuven Belgium
Department of Pathology Canisius Wilhelmina Hospital Nijmegen the Netherlands
Department of Pathology Elisabeth TweeSteden Hospital Tilburg the Netherlands
Department of Pathology Ghent University Hospital Cancer Research Institute Ghent Ghent Belgium
Department of Pathology Radboud university medical center Nijmegen the Netherlands
Department of Pathology Stichting PAMM Eindhoven the Netherlands
Department of Pathology University Hospital in Brno and Masaryk University Brno Czech Republic
Department of Pathology University of Turku Turku Finland
Department of Radiation Oncology Radboud university medical center Nijmegen the Netherlands
Gynecological Department Vall Hebron University Hospital CIBERONC Barcelona Spain
Pathology Department Vall Hebron University Hospital CIBERONC Barcelona Spain
References provided by Crossref.org
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