Prognostic significance of immunohistochemical markers in endometrial cancer treated with chemotherapy

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. e16551-e16551
Author(s):  
S. R. Lord ◽  
N. Vasudev ◽  
S. Knight ◽  
V. Speirs ◽  
G. Hall
Keyword(s):  
Endometrial Cancer ◽  
Prognostic Factors ◽  
Poor Prognosis ◽  
Early Stage ◽  
Good Prognosis ◽  
Serous Carcinoma ◽  
Positive Staining ◽  
Endometrioid Adenocarcinoma ◽  
Similar Frequency ◽  
Early Stage Endometrial Cancer

e16551 Background: The proportion of patients receiving chemotherapy for endometrial cancer is increasing both in the adjuvant and advanced setting. The literature describes many prognostic immunohistochemical factors in early stage endometrial cancer, the majority of whom will not receive chemotherapy. The aim of this study was to describe the biomarker expression for endometrial tumours treated with chemotherapy and to assess what constitutes a favourable and unfavourable profile for this patient group. Methods: For a subset of patients with either endometrioid, serous or a mixed mullerian morphology treated with chemotherapy at our centre between 1996 and 2008 an immunohistochemical profile of 14 biomarkers was studied (ERα, Erβ1, Erβ2, PR, PRB, P53, Rb, E-cad, MDM2, MIB-1, E2F1, p16, p13, and p21). A univariate analysis using cox regression of potential prognostic factors was then carried out. Results: In total 199 patients received chemotherapy for endometrial cancer over the 12 year period studied. Two year survival from commencement of chemotherapy for patients receiving adjuvant treatment was 45.2% and palliative treatment 28.1%. The commonest histological subtypes were endometrioid adenocarcinoma (40%), serous carcinoma (24.1%) and mixed mullerian tumours (14.6%). For the subset of 35 patients 38.2% of patients had positive immunohistochemical staining for ERα, 53% for PR, 73.5% for p16, and 94% for E2F1. Good prognosis was predicted by the strength of staining for E2F1 (HR 0.757, CI 0.216/0.902, p = 0.025) and poor prognosis by p16 (HR 1.470, CI 1.040/2.077, p = 0.029). Conclusions: Positive staining for ERα and PR was of similar frequency to previous studies of early stage endometrial cancer and did not significantly influence prognosis. Good prognosis correlated with E2F1 expression and poor prognosis with p16. A greater proportion of patients had serous morphology compared to published series of early stage endometrial cancer. Further study of prognostic factors in larger numbers of patients and built into prospective randomised trials may allow the creation of a prognostic model and guide the development of future clinical trials of targeted therapy. No significant financial relationships to disclose.

scholarly journals MRI-Based Radiomics Nomogram for Selecting Ovarian Preservation Treatment in Patients With Early-Stage Endometrial Cancer

2021 ◽  
Vol 11 ◽  
Author(s):  
Bi Cong Yan ◽  
Xiao Liang Ma ◽  
Ying Li ◽  
Shao Feng Duan ◽  
Guo Fu Zhang ◽  
...  
Keyword(s):  
Endometrial Cancer ◽  
Early Stage ◽  
Myometrial Invasion ◽  
Roc Curves ◽  
Primary Group ◽  
Endometrioid Adenocarcinoma ◽  
Validation Group ◽  
Cancer Antigen 125 ◽  
Ovarian Preservation ◽  
Early Stage Endometrial Cancer

BackgroundOvarian preservation treatment (OPT) was recommended in young women with early-stage endometrial cancer [superficial myometrial invasion (MI) and grades (G) 1/2-endometrioid adenocarcinoma (EEC)]. A radiomics nomogram was developed to assist radiologists in assessing the depth of MI and in selecting eligible patients for OPT.MethodsFrom February 2014 to May 2021, 209 G 1/2-EEC patients younger than 45 years (mean 39 ± 4.3 years) were included. Of them, 104 retrospective patients were enrolled in the primary group, and 105 prospective patients were enrolled in the validation group. The radiomics features were extracted based on multi-parametric magnetic resonance imaging, and the least absolute shrinkage and selection operator algorithm was applied to reduce the dimensionality of the data and select the radiomics features that correlated with the depth of MI in G 1/2-EEC patients. A radiomics nomogram for evaluating the depth of MI was developed by combing the selected radiomics features with the cancer antigen 125 and tumor size. Receiver operating characteristic (ROC) curves were used to evaluate the diagnostic performance of the radiomics nomogram and of radiologists without and with the aid of the radiomics nomogram. The net reclassification index (NRI) and total integrated discrimination index (IDI) based on the total included patients to assess the clinical benefit of radiologists with the radiomics nomogram were calculated.ResultsIn the primary group, for evaluating the depth of MI, the AUCs were 0.96 for the radiomics nomogram; 0.80 and 0.86 for radiologists 1 and 2 without the aid of the nomogram, respectively; and 0.98 and 0.98 for radiologists 1 and 2 with the aid of the nomogram, respectively. In the validation group, the AUCs were 0.88 for the radiomics nomogram; 0.82 and 0.83 for radiologists 1 and 2 without the aid of the nomogram, respectively; and 0.94 and 0.94 for radiologists 1 and 2 with the aid of the nomogram, respectively. The yielded NRI and IDI values were 0.29 and 0.43 for radiologist 1 and 0.23 and 0.37 for radiologist 2, respectively.ConclusionsThe radiomics nomogram outperformed radiologists and could help radiologists in assessing the depth of MI and selecting eligible OPTs in G 1/2-EEC patients.

scholarly journals Microsatellite instability leads to poor prognosis in patients with early-stage endometrial cancer? a meta-analysis

2020 ◽  
Author(s):  
Jingping Xiao ◽  
Jisheng Wang ◽  
Yuanyu Zhao ◽  
Miaoquan He ◽  
Jiang Du ◽  
...  
Keyword(s):  
Endometrial Cancer ◽  
Microsatellite Instability ◽  
Publication Bias ◽  
Poor Prognosis ◽  
Early Stage ◽  
Meta Analysis ◽  
Significant Heterogeneity ◽  
Free Survival ◽  
Independent Marker ◽  
Early Stage Endometrial Cancer

Abstract Background Poor prognosis of early-stage endometrial cancer (EC) is often accompanied by microsatellite instability (MSI). We hypothesized that MSI is an independent marker for poor prognosis of early-stage EC. To demonstrate this hypothesis, we evaluated the correlation between MSI and early-stage EC prognosis by meta-analysis. Methods Databases such as PubMed, EMBASE and the Cochrane Cooperative Library were searched from inception to October 2020, respectively. The disease-free survival (DFS), the overall survival (OS), and the progression-free survival (PFS) were pooled to analyze the correlation between MSI and prognosis in patients with early-stage EC. Besides, Egger's regression and Begg's test were used to detect Publication bias. Results There were 7 studies met the inclusion criteria and were enrolled in our meta-analysis with a sample size of 1150, and the included patients with early-stage EC were all endometrioid endometrial cancer (EEC). The pooled hazard ratios (HRs) in early-stage EC shows that MSI is significantly associated with lower DFS [HR = 3.90, 95%CI (2.81–6.99), p = 0.000], OS [HR = 1.48, 95%CI (1.12–1.96), p = 0.006], and PFS [HR = 2.41, 95%CI (1.05–5.52), p = 0.038]. There was no significant heterogeneity in the studies pooled analysis of DFS, OS, and PFS. There was also no statistical publication bias, the P-value of Egger`s test of OS and DFS is p = 0.535 and p = 0.639 respectively. Conclusion MSI is most likely an independent marker of poor prognosis in early-stage EC, and this correlation is even more significant in patients with EEC.

Rare case of stage IA epithelial ovarian cancer with bone as the first site of recurrent metastasis

2006 ◽  
Vol 16 (Suppl 1) ◽  
pp. 322-326 ◽  
Author(s):  
K.-H. Chang ◽  
J.-P. Lee ◽  
H.-S. Ryu
Keyword(s):  
Ovarian Cancer ◽  
Cervical Cancer ◽  
Endometrial Cancer ◽  
Epithelial Ovarian Cancer ◽  
Poor Prognosis ◽  
Rare Case ◽  
Advanced Disease ◽  
Early Stage ◽  
Good Prognosis ◽  
Stage Ia

Ovarian cancer is one of the main gynecological malignancies including cervical cancer and endometrial cancer. Epithelial ovarian cancer generally presents with already advanced disease at the time of diagnosis and is accompanied by poor prognosis. However, stage I ovarian cancer defined as lesions confined to the ovary is usually considered to have a good prognosis, illustrated by a 5-year survival rate of greater than 70–80%. Also, recurrences tend to be late and are usually in the abdominopelvic cavity. Metastases to the skeletal structures are rare. We report a rare case of early stage IA ovarian cancer, in which the first recurrent lesion was bone metastasis.

Endometrial Cancer

2017 ◽  
Author(s):  
Linda S. Cook ◽  
Angela L. W. Meisner ◽  
Noel S. Weiss
Keyword(s):  
Endometrial Cancer ◽  
Large Body ◽  
Case Fatality ◽  
Good Prognosis ◽  
Common Type ◽  
Reproductive Age ◽  
Serous Carcinoma ◽  
Endometrioid Adenocarcinoma ◽  
Type I ◽  
Endometrial Cancer Risk

Endometrial cancer is rare among women of reproductive age, but in older women can occur at an annual rate of up to 50 –100 per 100,000. The incidence varies more than five-fold across regions of the world, with the rates generally being highest in North America and Europe. Endometrial cancer can be classified into two broad histologic groups: the more common type I tumors (e.g., endometrioid adenocarcinoma), which have a relatively good prognosis (case-fatality in the neighborhood of 20%); and the less common type II tumors (e.g., serous carcinoma), which have a poorer prognosis. The endometrium is a hormone-responsive tissue, and there is a large body of evidence to support a hormonal basis for carciogenesis. Specifically, exposure to high levels of circulating estrogens increases endometrial cancer risk, especially for type I cancer, whereas exposure to progestogens reduces risk.

Sign in / Sign up

Export Citation Format

Share Document