Older age is no longer an adverse prognostic factor in women with early-stage endometrial carcinoma: A matched analysis

Abstract Background: Risk stratifications for endometrial carcinoma (EC) depend on histopathology and molecular pathology. Histopathological risk stratification lacks reproducibility, neglects heterogeneity and contributes little to surgical procedures. Existing molecular stratification is useless in patient with specific pathological or molecular characteristics, and cannot guide postoperative adjuvant radiotherapies. Chromosomal instability (CIN), the numerical and structural alterations of chromosome resulting from ongoing errors of chromosome segregation, is an intrinsic biological mechanism for the evolution of different prognostic factors of histopathology and molecular pathology, which may be applicable to the risk stratification of EC.Results: By analysis of CIN25 and CIN70, two reliable gene expression signatures for CIN, we found that EC with unfavorable prognostic factors of histopathology or molecular pathology had serious CIN. However, POLE-mutant, as a favorable prognostic factor, had elevated CIN signatures, and CTNNB1-mutant, as an unfavorable prognostic factor, had decreased CIN signatures. Only if these two mutations were excluded were CIN signatures strongly prognostic for outcomes in different adjuvant radiotherapy subgroups. Integrating pathology, CIN signatures and POLE / CTNNB1 mutation stratified stageⅠendometrioid EC into four groups with improved risk prognostication and treatment recommendations.Conclusions:We revealed the possibility of integrating histopathology and molecular pathology by CIN for risk stratification in early-stage EC. Our integrated risk model deserves for further improvement and validation.

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Myoinvasive Pattern as a Prognostic Marker in Low-Grade, Early-Stage Endometrioid Endometrial Carcinoma

Cancers ◽

10.3390/cancers11121845 ◽

2019 ◽

Vol 11 (12) ◽

pp. 1845 ◽

Cited By ~ 2

Author(s):

Ignacio Ruz-Caracuel ◽

Jorge L Ramón-Patino ◽

Álvaro López-Janeiro ◽

Laura Yébenes ◽

Alberto Berjón ◽

...

Keyword(s):

Prognostic Factor ◽

Microsatellite Instability ◽

Endometrial Carcinoma ◽

Early Stage ◽

Disease Free Survival ◽

Figo Stage ◽

Low Grade ◽

Gynecology And Obstetrics ◽

Endometrioid Endometrial Carcinoma ◽

Endometrial Carcinomas

Low-grade and early Federation for Gynecology and Obstetrics (FIGO) stage endometrioid endometrial carcinomas (EEC) have an excellent prognosis. However, approximately 10% of patients develop recurrence, which cannot be correctly predicted at diagnosis. We evaluated myoinvasive patterns as a prognostic factor of relapse in low-grade, early-stage EEC. Two-hundred and fifty-eight cases were selected according to the following inclusion criteria: (i) endometrioid endometrial carcinomas, (ii) grade 1 or 2 with (iii) FIGO stage I or II, and (iv) clinical follow-up. Slides were reviewed to annotate the myoinvasive pattern present in each case (infiltrative glands, microcystic, elongated and fragmented –MELF-, broad front, adenomyosis-like and adenoma malignum). Microsatellite instability was studied by immunoexpression of mismatch repair proteins (MLH1, PMS2, MSH2, and MSH6). There were 29 recurrences (11.2%) among the 258 cases analysed. A predominant broad front myoinvasive pattern was significantly associated with tumour relapse (p = 0.003). The presence of a pattern of infiltrative glands (p = 0.001) and microsatellite instability (p = 0.004) were associated with lower disease-free survival, without having an impact on overall survival. Our observations suggest the potential value of the pattern of myoinvasion as a prognostic factor in low-grade, early-stage endometrioid endometrial carcinoma.

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Integrating Pathology, Chromosomal Instability and Mutations for Risk Stratification in Early-stage Endometrioid Endometrial Carcinoma

10.21203/rs.3.rs-58862/v2 ◽

2020 ◽

Author(s):

Yuan Li ◽

Jiaqi Li ◽

Ensong Guo ◽

Jia Huang ◽

Guangguang Fang ◽

...

Keyword(s):

Prognostic Factors ◽

Prognostic Factor ◽

Risk Stratification ◽

Endometrial Carcinoma ◽

Molecular Pathology ◽

Chromosomal Instability ◽

Risk Model ◽

Early Stage ◽

Molecular Characteristics ◽

Molecular Stratification

Abstract Background: Risk stratifications for endometrial carcinoma (EC) depend on histopathology and molecular pathology. Histopathological risk stratification lacks reproducibility, neglects heterogeneity and contributes little to surgical procedures. Existing molecular stratification is useless in patients with specific pathological or molecular characteristics and cannot guide postoperative adjuvant radiotherapies. Chromosomal instability (CIN), the numerical and structural alterations of chromosomes resulting from ongoing errors of chromosome segregation, is an intrinsic biological mechanism for the evolution of different prognostic factors of histopathology and molecular pathology and may be applicable to the risk stratification of EC.Results: By analyzing CIN25 and CIN70, two reliable gene expression signatures for CIN, we found that EC with unfavorable prognostic factors of histopathology or molecular pathology had serious CIN. However, the POLE mutant, as a favorable prognostic factor, had elevated CIN signatures, and the CTNNB1 mutant, as an unfavorable prognostic factor, had decreased CIN signatures. Only if these two mutations were excluded were CIN signatures strongly prognostic for outcomes in different adjuvant radiotherapy subgroups. Integrating pathology, CIN signatures and POLE/CTNNB1 mutation stratified stageⅠendometrioid EC into four groups with improved risk prognostication and treatment recommendations. Conclusions: We revealed the possibility of integrating histopathology and molecular pathology by CIN for risk stratification in early-stage EC. Our integrated risk model deserves further improvement and validation.

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An elevated serum beta-2-microglobulin level is an adverse prognostic factor for overall survival in patients with early-stage Hodgkin disease

Cancer ◽

10.1002/cncr.10998 ◽

2002 ◽

Vol 95 (12) ◽

pp. 2534-2538 ◽

Cited By ~ 24

Author(s):

Gregory M. Chronowski ◽

Richard B. Wilder ◽

Susan L. Tucker ◽

Chul S. Ha ◽

Andreas H. Sarris ◽

...

Keyword(s):

Overall Survival ◽

Prognostic Factor ◽

Early Stage ◽

Elevated Serum ◽

Hodgkin Disease ◽

Adverse Prognostic Factor ◽

Beta 2 ◽

Beta 2 Microglobulin

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Integrating pathology, chromosomal instability and mutations for risk stratification in early-stage endometrioid endometrial carcinoma

Cell & Bioscience ◽

10.1186/s13578-020-00486-0 ◽

2020 ◽

Vol 10 (1) ◽

Author(s):

Yuan Li ◽

Jiaqi Li ◽

Ensong Guo ◽

Jia Huang ◽

Guangguang Fang ◽

...

Keyword(s):

Prognostic Factors ◽

Prognostic Factor ◽

Risk Stratification ◽

Endometrial Carcinoma ◽

Molecular Pathology ◽

Chromosomal Instability ◽

Risk Model ◽

Early Stage ◽

Molecular Characteristics ◽

Molecular Stratification

Abstract Background Risk stratifications for endometrial carcinoma (EC) depend on histopathology and molecular pathology. Histopathological risk stratification lacks reproducibility, neglects heterogeneity and contributes little to surgical procedures. Existing molecular stratification is useless in patients with specific pathological or molecular characteristics and cannot guide postoperative adjuvant radiotherapies. Chromosomal instability (CIN), the numerical and structural alterations of chromosomes resulting from ongoing errors of chromosome segregation, is an intrinsic biological mechanism for the evolution of different prognostic factors of histopathology and molecular pathology and may be applicable to the risk stratification of EC. Results By analyzing CIN25 and CIN70, two reliable gene expression signatures for CIN, we found that EC with unfavorable prognostic factors of histopathology or molecular pathology had serious CIN. However, the POLE mutant, as a favorable prognostic factor, had elevated CIN signatures, and the CTNNB1 mutant, as an unfavorable prognostic factor, had decreased CIN signatures. Only if these two mutations were excluded were CIN signatures strongly prognostic for outcomes in different adjuvant radiotherapy subgroups. Integrating pathology, CIN signatures and POLE/CTNNB1 mutation stratified stageIendometrioid EC into four groups with improved risk prognostication and treatment recommendations. Conclusions We revealed the possibility of integrating histopathology and molecular pathology by CIN for risk stratification in early-stage EC. Our integrated risk model deserves further improvement and validation.

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