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Grade and Estrogen Receptor Expression Identify a Subset of No Specific Molecular Profile Endometrial Carcinomas at a Very Low Risk of Disease-Specific Death.
Jamieson, Amy; Huvila, Jutta; Chiu, Derek; Thompson, Emily F; Scott, Stephanie; Salvador, Shannon; Vicus, Danielle; Helpman, Limor; Gotlieb, Walter; Kean, Sarah; Samouelian, Vanessa; Köbel, Martin; Kinloch, Mary; Parra-Harran, Carlos; Offman, Saul; Grondin, Katherine; Irving, Julie; Lum, Amy; Senz, Janine; Leung, Samuel; McConechy, Melissa K; Plante, Marie; Kommoss, Stefan; Huntsman, David G; Talhouk, Aline; Gilks, C Blake; McAlpine, Jessica N.
Afiliación
  • Jamieson A; Division of Gynecologic Oncology, Department of Gynecology and Obstetrics, University of British Columbia, Vancouver, British Columbia, Canada.
  • Huvila J; Department of Pathology, University of Turku, Turku University Hospital, Turku, Finland.
  • Chiu D; Department of Molecular Oncology, University of British Columbia, Vancouver, British Columbia, Canada.
  • Thompson EF; Department of Molecular Oncology, University of British Columbia, Vancouver, British Columbia, Canada.
  • Scott S; Division of Gynecologic Oncology, Department of Gynecology and Obstetrics, Dalhousie University, Halifax, Canada.
  • Salvador S; Division of Gynecologic Oncology, Department of Gynecology and Obstetrics, McGill University, Montreal, Canada.
  • Vicus D; Division of Gynecologic Oncology, Department of Gynecology and Obstetrics, University of Toronto, Toronto, Canada.
  • Helpman L; Division of Gynecologic Oncology, Department of Gynecology and Obstetrics, McMaster University, Hamilton, Ontario, Canada.
  • Gotlieb W; Division of Gynecologic Oncology, Department of Gynecology and Obstetrics, McGill University, Montreal, Canada.
  • Kean S; Division of Gynecologic Oncology, Department of Gynecology and Obstetrics, University of Manitoba, Winnipeg, Canada.
  • Samouelian V; Division of Gynecologic Oncology, Department of Gynecology and Obstetrics, University of Montreal, Montreal, Quebec, Canada.
  • Köbel M; Department of Pathology and Laboratory Medicine, University of Calgary, Calgary, Alberta, Canada.
  • Kinloch M; Department of Pathology, University of Saskatchewan, Saskatoon, Saskatchewan, Canada.
  • Parra-Harran C; Department of Pathology, University of Toronto, Toronto, Ontario, Canada.
  • Offman S; Department of Pathology, Dalhousie University, Halifax, Nova Scotia, Canada.
  • Grondin K; Department of Pathology, Laval University, Quebec City, Quebec, Canada.
  • Irving J; Department of Pathology, University of British Columbia, Vancouver, British Columbia, Canada.
  • Lum A; Department of Molecular Oncology, University of British Columbia, Vancouver, British Columbia, Canada.
  • Senz J; Department of Molecular Oncology, University of British Columbia, Vancouver, British Columbia, Canada.
  • Leung S; Department of Molecular Oncology, University of British Columbia, Vancouver, British Columbia, Canada.
  • McConechy MK; Imagia Canexia Health, Inc., Vancouver, British Columbia, Canada.
  • Plante M; Division of Gynecologic Oncology, Department of Gynecology and Obstetrics, Laval University, Quebec City, Quebec, Canada.
  • Kommoss S; Department of Women's Health, Tübingen University Hospital, Tübingen, Germany.
  • Huntsman DG; Department of Molecular Oncology, University of British Columbia, Vancouver, British Columbia, Canada; Department of Pathology, University of British Columbia, Vancouver, British Columbia, Canada; Imagia Canexia Health, Inc., Vancouver, British Columbia, Canada.
  • Talhouk A; Department of Molecular Oncology, University of British Columbia, Vancouver, British Columbia, Canada.
  • Gilks CB; Department of Pathology, University of British Columbia, Vancouver, British Columbia, Canada. Electronic address: blake.gilks@vch.ca.
  • McAlpine JN; Division of Gynecologic Oncology, Department of Gynecology and Obstetrics, University of British Columbia, Vancouver, British Columbia, Canada. Electronic address: jessica.mcalpine@vch.ca.
Mod Pathol ; 36(4): 100085, 2023 04.
Article en En | MEDLINE | ID: mdl-36788084
Endometrial carcinoma (EC) can be divided into 4 prognostic molecular subtypes, and no specific molecular profile (NSMP) type is the most commonly occurring type (∼50%). Although described as having an intermediate to favorable prognosis, this subtype encompasses pathologically and molecularly diverse tumors. We aimed to identify factors associated with outcomes within the NSMP ECs that might be used to stratify prognosis and direct treatment. Clinicopathologic, immunohistochemical, and genetic features of a large series of NSMP EC were used to identify parameters that could identify the subset associated with a very favorable outcome (disease-specific death rate <5% at 5 years, termed low-risk NSMP). A total of 1110 NSMP ECs were profiled. In a univariate analysis, stage, grade, lymphovascular invasion, estrogen receptor (ER) and progesterone receptor (PR) expression, L1CAM overexpression, and mutations in PIK3CA were associated with disease-specific survival. Two critical features, grade and ER expression, identified a low-risk NSMP subset (grade 1-2, ER-positive [>1%], 84% of cases), which showed a 5-year disease-specific death rate of 1.6% across all stages and 1.4% within stage I. The remaining cases (high-risk NSMPs, grade 3, and/or ER-negative status) were responsible for most of the disease-specific deaths (disease-specific death rate at 5 years, 22.9%; hazard ratio compared with that of low-risk NSMPs: 16.3; 95% CI, 8.4-31.7). Within NSMP EC, the low-risk and high-risk categories were of prognostic significance independent of the stage on a multivariate analysis. Low-grade and ER-positive NSMP ECs are a homogeneous low-risk group associated with an exceptionally favorable prognosis in which de-escalation and/or endocrine therapy strategies can be applied. Grade 3 and/or ER-negative status identifies a high-risk NSMP subset, including rare high-grade histotypes (eg, clear cell, dedifferentiated, and mesonephric-like), responsible for most NSMP-related deaths. Subclassification of NSMPs allows for the category of low-risk EC molecular subtypes to be dramatically expanded because it now includes both POLEmut and the much more common low-risk NSMP EC.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neoplasias Endometriales / Carcinoma Endometrioide Tipo de estudio: Etiology_studies / Prognostic_studies / Risk_factors_studies Límite: Female / Humans Idioma: En Revista: Mod Pathol Asunto de la revista: PATOLOGIA Año: 2023 Tipo del documento: Article País de afiliación: Canadá Pais de publicación: Estados Unidos

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neoplasias Endometriales / Carcinoma Endometrioide Tipo de estudio: Etiology_studies / Prognostic_studies / Risk_factors_studies Límite: Female / Humans Idioma: En Revista: Mod Pathol Asunto de la revista: PATOLOGIA Año: 2023 Tipo del documento: Article País de afiliación: Canadá Pais de publicación: Estados Unidos