Journal
GYNECOLOGIC ONCOLOGY
Volume 148, Issue 2, Pages 258-266Publisher
ACADEMIC PRESS INC ELSEVIER SCIENCE
DOI: 10.1016/j.ygyno.2017.11.027
Keywords
Endometrial cancer; Survival; Hormone receptor status; ER; PR
Categories
Funding
- NSW: John Hunter Hospital
- NSW: Liverpool Hospital
- NSW: Mater Misericordiae Hospital (Sydney)
- NSW: Mater Misericordiae Hospital (Newcastle)
- NSW: Newcastle Private Hospital
- NSW: North Shore Private Hospital
- NSW: Royal Hospital for Women
- NSW: Royal Prince Alfred Hospital
- NSW: Royal North Shore Hospital
- NSW: St George Hospital
- Westmead Hospital
- Westmead Private Hospital
- QLD: Brisbane Private Hospital
- QLD: Greenslopes Hospital
- QLD: Mater Misericordiae Hospitals
- QLD: Royal Brisbane and Women's Hospital
- QLD: Wesley Hospital
- QLD: Queensland Cancer Registry
- SA: Adelaide Pathology Partners
- SA: Burnside Hospital
- SA: Calvary Hospital
- SA: Flinders Medical Centre
- SA: Queen Elizabeth Hospital
- SA: Royal Adelaide Hospital
- SA: South Australian Cancer Registry
- TAS: Launceston Hospital
- TAS: North West Regional Hospitals
- TAS: Royal Hobart Hospital
- VIC: Freemasons Hospital
- VIC: Melbourne Pathology Services
- VIC: Mercy Hospital for Women
- VIC: Royal Women's Hospital
- VIC: Victorian Cancer Registry
- WA: King Edward Memorial Hospital
- WA: St John of God Hospitals Subiaco Murdoch
- WA: Western Australian Cancer Registry
- National Health and Medical Research Council (NHMRC) of Australia [339435]
- Cancer Council Queensland [4196615]
- Cancer Council Tasmania [403031, 457636]
- Cancer Australia Priority-driven Collaborative Cancer Research Scheme [552468]
- Cancer Australia [1010859]
- Royal Brisbane and Women's Hospital Foundation
- Queensland Institute of Medical Research
- NHMRC Senior Research Fellowships
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Objective. To measure association between endometrial carcinoma ER and PR status and endometrial cancer (EC) survival, accounting for inter-observer variation. Methods. The intensity and proportion of tumor cell expression of ER and PR in ECs were assessed independently and semi-quantitatively by two pathologists using digital images of duplicate tumor tissue microarrays (TMAs). Cases with inconsistent initial assessment were reviewed and final scoring agreed. The association between overall and EC-specific survival and hormone receptor expression (intensity, proportion and combined) was assessed using Cox regression analysis. The C-index was used to evaluate model discrimination with addition of ER and PR status. Results. Tumor ER and PR analysis was possible in 659 TMAs from 255 patients, and in 459 TMAs from 243 patients, respectively. Initial ER and PR scoring was consistent in 82% and 80% of cases, respectively. In multivariate analyses decreased ER and PR expression was associated with increased tumor-related mortality. Associations reached statistical significance for ER proportion score (P = 0.05), ER intensity score (P = 0.003), and PR combined score (P = 0.04). Decreased expression of combined ER/PR expression was associated with poorer EC-specific survival than decreased expression of either hormone receptor alone (P = 0.005). However, hormone receptor status did not significantly improve mortality prediction in individual cases. Conclusion. ER and PR expression combined, using cut-points that capture variation in scoring and across cores, is significantly associated with EC-specific survival in analyses adjusting for known prognostic factors. However, at the individual level, ER and PR expression does not improve mortality prediction. (C) 2017 Elsevier Inc. All rights reserved.
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