4.6 Article

Molecular markers in recurrent stage I, grade 1 endometrioid endometrial cancers

Journal

GYNECOLOGIC ONCOLOGY
Volume 153, Issue 3, Pages 517-520

Publisher

ACADEMIC PRESS INC ELSEVIER SCIENCE
DOI: 10.1016/j.ygyno.2019.03.100

Keywords

Endometrial cancer; Molecular testing; Risk-stratification

Funding

  1. Women's Cancer Developmental Therapeutics Program of the University of Colorado

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Objectives. Stage I, grade 1 endometrial cancers have low recurrence rates and often do not receive adjuvant therapy. We compared recurrent cases to matched non-recurrent controls to evaluate for molecular markers associated with higher risk of recurrence. Methods. A case-control study including all cases of recurrent stage I, grade 1 endometrioid endometrial cancer at one institution in a ten-year period. Cases were matched to controls by age, BMI, weight and stage. Molecular testing and immunohistochemistry were performed on archival tumor specimens: microsatellite instability (MSI-H), mismatch repair status, POLE mutational status, and next-generation sequencing. Results. 15 stage I, grade 1 endometrial cancer cases with recurrent disease and available tumor specimens were identified. CTNNB1 and MSI-H were present at significantly higher rates in cases than controls (CTNNB1 60% vs. 28%, OR 3.9, 95%Cl 1.1-14.7, p = 0.04 and MSI-H 53% vs. 21%, OR 4.4, 95%Cl 1.1-17.0, p = 0.03). POLE mutations were found in 0% of cases vs. 7% of controls (p = 0.54). Among specimens demonstrating microsatellite stability (MSS), 100% of cases vs. 26% of controls had CTNNBI mutations (p < 0.001). CTNNBI wild type tumors were MSI-H in 100% of cases vs. 19% of controls (p < 0.001). Conclusions. Compared to controls, CTNNB1 mutation is present at significantly higher rates in recurrent stage I, grade 1 endometrial cancers and is found most commonly in MSS tumors. MSI-H is also present at significantly higher rates in recurrent cases. These markers may be useful for prognostic risk stratification and adjuvant therapy decision-making in this otherwise low-risk population. (C) 2019 Elsevier Inc. All rights reserved.

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