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@proceedings{2233440,
author = {Vrede, S and Kasius, J and Bulten, J and Van Weelden W, J and Boll, D and Vos, M C and Van Altena, A and MatiasandGuiu, X and Asberger, J and Colas, E and GilandMoreno, A and Huvila, J and Weinberger, Vít and Amant, F and Snijders, M and KustersandVandevelde, H and Eijkelenboom, A and Kruitwagen, R and Reijnen, C and Pijnenborg, J M},
booktitle = {ESMO Gynaecological Cancers Congress,Valencia, Spain, 17-18 June 2022},
doi = {http://dx.doi.org/10.1016/j.annonc.2022.04.039},
language = {eng},
title = {Limited benefit of molecular profiling in patients with low-grade endometrial cancer},
url = {https://www.annalsofoncology.org/article/S0923-7534(22)00724-4/fulltext},
year = {2022}
}
TY - CONF
ID - 2233440
AU - Vrede, S - Kasius, J - Bulten, J - Van Weelden W, J - Boll, D - Vos, M C - Van Altena, A - Matias-Guiu, X - Asberger, J - Colas, E - Gil-Moreno, A - Huvila, J - Weinberger, Vít - Amant, F - Snijders, M - Kusters-Vandevelde, H - Eijkelenboom, A - Kruitwagen, R - Reijnen, C - Pijnenborg, J M
PY - 2022
TI - Limited benefit of molecular profiling in patients with low-grade endometrial cancer
UR - https://www.annalsofoncology.org/article/S0923-7534(22)00724-4/fulltext
N2 - Background Most patients present with low-grade (grade 1-2) early-stage (FIGO I-II) endometrioid EC (EEC), it is questioned whether these patients benefit from molecular profiling. We aim to investigate the prognostic relevance of molecular profiling within low-grade EEC. Methods A retrospective multicenter study within the European Network for Individualized Treatment (ENITEC) network. Patients with early-stage EC were excluded if lymph node status was unknown. Molecular profiling was conducted using single-molecule Molecular Inversion Probes based on Next Generation Sequencing. Subsequently, cases were classified as: polymerase epsilon (POLE) mutant, microsatellite instable (MSI), tumor protein (TP53) mutation and no-specific molecular profile (NSMP). Results Total of 393 EC patients were included, 75% had early-stage EC, and 54% low-grade EEC. Of all patients, 8.1% was classified as POLEmut, 16.8% as MSI, 21.4% as TP53-mutated and 53.7% as NSMP. Median follow-up was 5.3-years. Across all molecular subgroups, patients with low-grade EEC had superior disease-specific survival (DSS) compared to high-grade (grade 3) EC, respectively >89% vs. >43%. Equally, patients with low-grade EEC had improved recurrence-free survival (RFS) compared to high-grade EC within POLEmut, MSI and NSMP. Within TP53-mutated, only grade 1 EEC showed an excellent RFS (92%) when compared to grade 2 (54%) and grade 3 EC (44%). In multivariate analysis that included age, lymphovascular space invasion, grade, FIGO stage and the four molecular subgroups, TP53-mutated, high-grade and advanced-stage (FIGO III-IV) remained independent prognostic factors for reduced DSS and RFS (respectively, hazard ratio (HR) 9.20 (95%-CI 1.23-68.90) p=0.031, HR 5.91 (95%-CI 2.63-13.28) p<0.001, HR 3.02 (95%-CI 1.61-5.62) p<0.001 and respectively, HR 12.27 (95%-CI 1.66-90.78) p=0.014, HR 2.66 (95%-CI 1.54-4.57) p<0.001, HR 2.58 (95%-CI 1.56-4.24) p<0.001). Conclusions Patients with grade 1 EEC have an excellent prognostic outcome across all molecular subgroups. In patients with grade 2 EEC, TP53-mutated seems to be prognostic relevant. Based on current data, routine molecular profiling in patients with low-grade EEC has shown limited contributive value to prognostic outcome.
ER -
VREDE, S, J KASIUS, J BULTEN, J VAN WEELDEN W, D BOLL, M C VOS, A VAN ALTENA, X MATIAS-GUIU, J ASBERGER, E COLAS, A GIL-MORENO, J HUVILA, Vít WEINBERGER, F AMANT, M SNIJDERS, H KUSTERS-VANDEVELDE, A EIJKELENBOOM, R KRUITWAGEN, C REIJNEN and J M PIJNENBORG. Limited benefit of molecular profiling in patients with low-grade endometrial cancer. In \textit{ESMO Gynaecological Cancers Congress,Valencia, Spain, 17-18 June 2022}. 2022. Available from: https://dx.doi.org/10.1016/j.annonc.2022.04.039.
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