Real-world impact of lymph node assessment on adjuvant
management in p53-abnormal endometrial carcinoma: a
retrospective multicenter cohort from Central Europe

J 2026

Real-world impact of lymph node assessment on adjuvant management in p53-abnormal endometrial carcinoma: a retrospective multicenter cohort from Central Europe

BRETOVA, Petra; Munachiso Iheme NDUKWE; Martina ROMANOVA; Pavel KABELE; Michaela KOBLÍŽKOVÁ et al.

Základní údaje

Originální název

Real-world impact of lymph node assessment on adjuvant management in p53-abnormal endometrial carcinoma: a retrospective multicenter cohort from Central Europe

Autoři

Vydání

International journal of gynecological cancer, LONDON, BMJ PUBLISHING GROUP, 2026, 1048-891X

Další údaje

Jazyk

angličtina

Typ výsledku

Článek v odborném periodiku

Obor

30214 Obstetrics and gynaecology

Stát vydavatele

Velká Británie a Severní Irsko

Utajení

není předmětem státního či obchodního tajemství

Odkazy

URL

Impakt faktor

Impact factor: 4.700 v roce 2024

Označené pro přenos do RIV

Ano

Organizační jednotka

Lékařská fakulta

Klíčová slova anglicky

Endometrial Carcinoma; p53-Abnormal; Molecular Classification; Lymph Node Staging; Adjuvant Therapy

Štítky

14110240, rivok

Příznaky

Mezinárodní význam, Recenzováno

Změněno: 5. 5. 2026 11:52, Mgr. Tereza Miškechová

Anotace

V originále

Objective: To determine how often lymph node assessment alters post-operative risk classification or adjuvant therapy in p53-abnormal endometrial carcinoma and to calculate the number needed to stage to obtain 1 management-changing result. Methods: This multicenter retrospective study included patients with biopsy-confirmed p53-abnormal endometrial carcinoma who underwent pre-operative expert ultrasound, molecular classification, and definitive surgery. Pre-operative risk groups were based on ultrasound-assessed invasion and molecular subtype; post-operative groups incorporated final pathology and lymph node status. The number needed to stage was defined as the number of patients staged divided by the number with management-changing results. Results: Among 120 patients, lymph node status was evaluable in 107, with metastases identified in 19 (17.8%) cases. Concordance between pre-operative and postoperative risk groups was 84.2%. Reclassification occurred in 15.8% of patients and was driven entirely by uterine pathological findings. Lymph node findings altered guideline-based post-operative management in only 2 of 107 patients (1.9%; 95% confidence interval 0.2% to 6.6%), both through treatment de-escalation based on negative nodal status. No escalation of adjuvant therapy was triggered by nodal metastases. The number needed to stage was 53.5. Conclusions: In this multicenter cohort of p53-abnormal endometrial carcinoma, lymph node assessment had a limited impact on guideline-based post-operative management, with treatment decisions largely driven by molecular subtype and uterine pathological factors. Prospective, molecularly stratified studies are needed to clarify the optimal role of nodal staging in this patient population.

Citovat

BRETOVA, Petra; Munachiso Iheme NDUKWE; Martina ROMANOVA; Pavel KABELE; Michaela KOBLÍŽKOVÁ; Jindrich GOBEL; Konrad MUZYKIEWICZ; Tatana RESLOVA; Jan KUMMEL; Denisa POHANKOVA; Vít WEINBERGER; Dominik HABES; Malgorzata NOWAK-JASTRZĄB; Igor SIRAK a Michal ZIKAN. Real-world impact of lymph node assessment on adjuvant management in p53-abnormal endometrial carcinoma: a retrospective multicenter cohort from Central Europe. International journal of gynecological cancer. LONDON: BMJ PUBLISHING GROUP, 2026, roč. 36, č. 5, s. 1-6. ISSN 1048-891X. Dostupné z: https://doi.org/10.1016/j.ijgc.2026.104633.

@article{2570578,
   author = {Bretova, Petra and Ndukwe, Munachiso Iheme and Romanova, Martina and Kabele, Pavel and Koblížková, Michaela and Gobel, Jindrich and Muzykiewicz, Konrad and Reslova, Tatana and Kummel, Jan and Pohankova, Denisa and Weinberger, Vít and Habes, Dominik and NowakandJastrząb, Malgorzata and Sirak, Igor and Zikan, Michal},
   article_location = {LONDON},
   article_number = {5},
   doi = {https://doi.org/10.1016/j.ijgc.2026.104633},
   keywords = {Endometrial Carcinoma; p53-Abnormal; Molecular Classification; Lymph Node Staging; Adjuvant Therapy},
   language = {eng},
   issn = {1048-891X},
   journal = {International journal of gynecological cancer},
   title = {Real-world impact of lymph node assessment on adjuvant management in p53-abnormal endometrial carcinoma: a retrospective multicenter cohort from Central Europe},
   url = {https://www.sciencedirect.com/science/article/pii/S1048891X26001647?via%3Dihub},
   volume = {36},
   year = {2026}
}

TY  - JOUR
ID  - 2570578
AU  - Bretova, Petra - Ndukwe, Munachiso Iheme - Romanova, Martina - Kabele, Pavel - Koblížková, Michaela - Gobel, Jindrich - Muzykiewicz, Konrad - Reslova, Tatana - Kummel, Jan - Pohankova, Denisa - Weinberger, Vít - Habes, Dominik - Nowak-Jastrząb, Malgorzata - Sirak, Igor - Zikan, Michal
PY  - 2026
TI  - Real-world impact of lymph node assessment on adjuvant management in p53-abnormal endometrial carcinoma: a retrospective multicenter cohort from Central Europe
JF  - International journal of gynecological cancer
VL  - 36
IS  - 5
SP  - 1-6
EP  - 1-6
PB  - BMJ PUBLISHING GROUP
SN  - 1048891X
KW  - Endometrial Carcinoma
KW  - p53-Abnormal
KW  - Molecular Classification
KW  - Lymph Node Staging
KW  - Adjuvant Therapy
UR  - https://www.sciencedirect.com/science/article/pii/S1048891X26001647?via%3Dihub
N2  - Objective: To determine how often lymph node assessment alters post-operative risk classification or adjuvant therapy in p53-abnormal endometrial carcinoma and to calculate the number needed to stage to obtain 1 management-changing result. Methods: This multicenter retrospective study included patients with biopsy-confirmed p53-abnormal endometrial carcinoma who underwent pre-operative expert ultrasound, molecular classification, and definitive surgery. Pre-operative risk groups were based on ultrasound-assessed invasion and molecular subtype; post-operative groups incorporated final pathology and lymph node status. The number needed to stage was defined as the number of patients staged divided by the number with management-changing results. Results: Among 120 patients, lymph node status was evaluable in 107, with metastases identified in 19 (17.8%) cases. Concordance between pre-operative and postoperative risk groups was 84.2%. Reclassification occurred in 15.8% of patients and was driven entirely by uterine pathological findings. Lymph node findings altered guideline-based post-operative management in only 2 of 107 patients (1.9%; 95% confidence interval 0.2% to 6.6%), both through treatment de-escalation based on negative nodal status. No escalation of adjuvant therapy was triggered by nodal metastases. The number needed to stage was 53.5. Conclusions: In this multicenter cohort of p53-abnormal endometrial carcinoma, lymph node assessment had a limited impact on guideline-based post-operative management, with treatment decisions largely driven by molecular subtype and uterine pathological factors. Prospective, molecularly stratified studies are needed to clarify the optimal role of nodal staging in this patient population.
ER  -

BRETOVA, Petra; Munachiso Iheme NDUKWE; Martina ROMANOVA; Pavel KABELE; Michaela KOBLÍŽKOVÁ; Jindrich GOBEL; Konrad MUZYKIEWICZ; Tatana RESLOVA; Jan KUMMEL; Denisa POHANKOVA; Vít WEINBERGER; Dominik HABES; Malgorzata NOWAK-JASTRZĄB; Igor SIRAK a Michal ZIKAN. Real-world impact of lymph node assessment on adjuvant management in p53-abnormal endometrial carcinoma: a retrospective multicenter cohort from Central Europe. \textit{International journal of gynecological cancer}. LONDON: BMJ PUBLISHING GROUP, 2026, roč.~36, č.~5, s.~1-6. ISSN~1048-891X. Dostupné z: https://doi.org/10.1016/j.ijgc.2026.104633.

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