scholarly journals Pre-treatment risk assessment of women with endometrial cancer: differences in outcomes of molecular and clinical classifications in the Slovenian patient cohort

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Jure Knez ◽  
Monika Sobocan ◽  
Urska Belak ◽  
Rajko Kavalar ◽  
Mateja Zupin ◽  
...  
Keyword(s):  
Risk Assessment ◽  
Endometrial Cancer ◽  
European Society ◽  
Molecular Classification ◽  
Intermediate Risk ◽  
Clinical Risk ◽  
Mutational Status ◽  
Clinical Risk Assessment ◽  
Personalized Risk Assessment ◽  
Personalized Risk

Abstract Background The aim of this study was to evaluate changes in prognostic risk profiles of women with endometrial cancer by comparing the clinical risk assessment with the integrated molecular risk assessment profiling. Patients and methods This prospective study recruited patients with biopsy proven endometrial cancer treated at the University Medical Centre Maribor between January 2020 to February 2021. Patient clinical data was assessed and categorized according to the currently valid European Society of Gynaecological Oncology, European SocieTy for Radiotherapy and Oncology, and European Society of Pathology (ESGO/ESTRO/ESP) guidelines on endometrial cancer. Molecular tumour characterization included determination of exonuclease domain of DNA polymerase-epsilon (POLE) mutational status by Sanger sequencing and imunohistochemical specimen evaluation on the presence of mismatch repair deficiencies (MMRd) and p53 abnormalities (p53abn). Results Fourty-five women were included in the study. Twenty-two tumours were of non-specific mutational profile (NSMP) (56.4%), 13 were classified as MMRd (33.3%), 3 were classified as p53abn (7.7%) and 1 was classified as POLE mutated (2.6%). Six tumours (15.4%) had multiple molecular classifiers, these were studied separately and were not included in the risk assessment. The clinical risk-assessment classified 21 women (53.8%) as low-risk, 5 women (12.8%) as intermediate risk, 2 women as high-intermediate risk (5.1%), 10 women (25.6%) as high risk and 1 patient as advanced metastatic (2.6%). The integrated molecular classification changed risk for 4 women (10.3%). Conclusions Integrated molecular risk improves personalized risk assessment in endometrial cancer and could potentially improve therapeutic precision. Further molecular stratification with biomarkers is especially needed in the NSMP group to improve personalized risk-assessment.

Cost-analysis comparison of initial clinical risk assessment and ROMA score for the triage of women with pelvic masses

2021 ◽  
Vol 162 ◽  
pp. S120-S121
Author(s):  
Kaylee Underkofler ◽  
Alexandra Morell ◽  
Rianne Esquivel ◽  
Francesca De Simone ◽  
Michael Miller ◽  
...  
Keyword(s):  
Risk Assessment ◽  
Cost Analysis ◽  
Clinical Risk ◽  
Pelvic Masses ◽  
Clinical Risk Assessment

Practical aspects of clinical risk assessment and management

1997 ◽  
Vol 170 (S32) ◽  
pp. 32-34 ◽  
Author(s):  
Peter Snowden
Keyword(s):  
Risk Assessment ◽  
Clinical Staff ◽  
Home Office ◽  
Clinical Risk ◽  
Utilitarian Value ◽  
Harm To Others ◽  
Clinical Risk Assessment ◽  
Risk Assessment And Management

It is debatable whether the notion of dangerousness now has any utilitarian value for psychiatry. The presence or absence of dangerousness is very much in the eye of the beholder. It is an all or nothing term – you either have it or you do not! While there is usually little disagreement about the few very violent individuals “who, for 24 hours a day, and in any situation, are likely to cause harm to others” (Chiswick, 1995), most patients are not in this category and “little bit dangerous” is unlikely to be of much comfort to clinical staff. It is unhelpful to deny that dangerousness is any more than an adjective which has been elevated into a pseudoscientific construct whose definitions (Scott, 1977; Walker, 1978; Home Office & DHSS, 1975) amount to little more than “past harm predicts future behaviour”.

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