Endometrial carcinoma molecular subtype correlates with the presence of lymph node metastases

Jamieson, Amy; Thompson, Emily F.; Huvila, Jutta; Leung, Samuel; Lum, Amy; Morin, Chantale; Ennour‐Idrissi, Kaoutar; Sebastianelli, Alexandra; Renaud, Marie-Claude; Grégoire, Jean; Huntsman, David G.; Gilks, C. Blake; Plante, Marie; Grondin, Katherine; McAlpine, Jessica N.

doi:10.1016/j.ygyno.2022.01.025

Cited by 32 publications

(32 citation statements)

References 28 publications

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“…The lymphatic disease was observed in 14.2%, 14.9%, 10.8%, and 44.8% of patients with POLE mut, MMRd, NSMMP, and p53abn, respectively. Although other prospective studies have to confirm this correlation, these data are of paramount importance since to the high accuracy of the molecular analysis on preoperative endometrial biopsies [37]. Additionally, the molecular analysis might have a strong supportive role in informing potential risks of not treating patients with low volume lymph node disease.…”

Section: Low Volume Disease In the Era Of Molecular/genomic Profilingmentioning

confidence: 93%

“…In this retrospective research, 31 (18.1%) out of 171 endometrial cancer patients had disease harboring in the lymph nodes. Of note, lymphatic disease included: macrometastases, micrometastases, and isolated tumor cells in 19 (61.3%), 5 (16.1%), and 7 (22.6%) patients, respectively [37]. The authors observed a strong association between lymph node involvement and molecular subtypes, being patients with p53 abnormal at high risk of lymphatic spread.…”

Section: Low Volume Disease In the Era Of Molecular/genomic Profilingmentioning

confidence: 93%

“…Recently, Jamieson A et al, evaluated the association between molecular subtype and lymph node metastases [37]. In this retrospective research, 31 (18.1%) out of 171 endometrial cancer patients had disease harboring in the lymph nodes.…”

Section: Low Volume Disease In the Era Of Molecular/genomic Profilingmentioning

confidence: 98%

See 2 more Smart Citations

Assessing the role of low volume disease in endometrial cancer

Bogani

Palaia

Perniola

et al. 2022

European Journal of Obstetrics & Gynecology and Reproductiv

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Section: Low Volume Disease In the Era Of Molecular/genomic Profilingmentioning

confidence: 93%

Section: Low Volume Disease In the Era Of Molecular/genomic Profilingmentioning

confidence: 93%

See 1 more Smart Citation

Assessing the role of low volume disease in endometrial cancer

Bogani

Palaia

Perniola

et al. 2022

European Journal of Obstetrics & Gynecology and Reproductiv

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“…Patients with POLE exonuclease domain mutation (EDM) may not need to undergo lymphadenectomy, as none of the POLE EDM tumors had extrauterine disease [ 171 ]. Lymph node metastasis was observed in 45% of p53-mutant tumors [ 172 ], although p53 abnormality may not be accurately detected in preoperative biopsy specimens, as preoperative biopsy did not show abnormal p53 staining in 56% of the tumors that showed p53 overexpression in hysterectomy specimens [ 167 ]. Lymphadenectomy may not improve patients with p53-mutant tumors, as the poor prognosis of early-stage p53-mutant endometrial cancers [ 173 , 174 , 175 , 176 ] may not be due to undetected lymph node metastasis [ 175 ].…”

Section: Preoperative Prediction Of Lymph Node Metastasis and Surgica...mentioning

confidence: 99%

Therapeutic Benefit of Systematic Lymphadenectomy in Node-Negative Uterine-Confined Endometrioid Endometrial Carcinoma: Omission of Adjuvant Therapy

Otsuka

2022

Cancers

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Endometrial cancer is the most common gynecological tract malignancy in developed countries, and its incidence has been increasing globally with rising obesity rates and longer life expectancy. In endometrial cancer, extrauterine disease, in particular lymph node metastasis, is an important prognostic factor. Nevertheless, pelvic lymphadenectomy is not considered to have a therapeutic benefit, as it did not improve survival in randomized studies. However, lymphadenectomy may have a therapeutic benefit if adjuvant therapy can be omitted without decreasing oncological outcomes, as the long-term quality of life is maintained by avoiding morbidities associated with adjuvant therapy. In intermediate- and high-risk endometrioid endometrial carcinomas, adjuvant therapy may be safely omitted without decreasing long-term survival by open surgery including systematic pelvic and para-aortic lymphadenectomy when patients are node-negative. Systematic lymphadenectomy may remove undetectable low-volume lymph node metastasis in both pelvic and para-aortic regions, and open surgery may reduce vaginal recurrence even without vaginal brachytherapy. However, lymphadenectomy may not improve survival in elderly patients and patients with p53-mutant tumors. In this review, I discuss the characteristics of lymph node metastasis, the methods of lymph node assessment, and the therapeutic benefits of systematic lymphadenectomy in patients with intermediate- and high-risk endometrioid endometrial carcinoma.

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“…They then provide management guidelines for adjuvant therapy based on these molecular subtypes. Recent investigations have shown that molecular subtyping can identify low-risk cancers among clinicopathologically high-risk tumors, and vice versa 4. Additionally, the testing of high- and high-intermediate risk cancers has been shown to be cost-effective compared with no testing or mismatch repair testing only in a US-based cost-effectiveness analysis 5.…”

mentioning

confidence: 99%