ESGO/ESTRO/ESP guidelines for the management of patients with endometrial carcinoma

Concin, Nicole; Matías‐Guiu, Xavier; Vergote, Ignace; Cibula, David; Mirza, Mansoor Raza; Marnitz, Simone; Ledermann, Jonathan A.; Bosse, Tjalling; Chargari, Cyrus; Fagotti, Anna; Fotopoulou, Christina; Martín, Antonio González; Lax, Sigurd; Lorusso, Domenica; Marth, Christian; Morice, Philippe; Nout, Remi A.; O’Donnell, D.; Querleu, Denis; Raspollini, Maria Rosaria; Sehouli, Jalid; Sturdza, Alina; Taylor, Alexandra; Westermann, Anneke M.; Wimberger, Pauline; Colombo, Nicoletta; Planchamp, François; Creutzberg, Carien L.

doi:10.1136/ijgc-2020-002230

Cited by 1,142 publications

(1,653 citation statements)

References 414 publications

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“…The current European pathologic classification of EC is probably not sufficiently accurate to predict recurrence risk, often leading to over-or under-treatment [167]. Sensitive and specific molecular prognostic biomarkers are needed to better adapt surgery and adjuvant therapies.…”

Section: Discussionmentioning

confidence: 99%

MicroRNA as Epigenetic Modifiers in Endometrial Cancer: A Systematic Review

Favier

Rocher

Larsen

et al. 2021

Cancers

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The objective of this systematic review is to summarize our current knowledge on the influence of miRNAs in the epigenetic deregulation of tumor-related genes in endometrial cancer (EC). We conducted a literature search on the role of miRNAs in the epigenetic regulation of EC applying the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The following terms were used: microRNA, miRNA, miR, endometrial cancer, endometrium, epigenetic, epimutation, hypermethylation, lynch, deacetylase, DICER, novel biomarker, histone, chromatin. The miRNAs were classified and are presented according to their function (tumor suppressor or onco-miRNA), their targets (when known), their expression levels in EC tissue vs the normal surrounding tissue, and the degree of DNA methylation in miRNA loci and CpG sites. Data were collected from 201 articles, including 190 original articles, published between November 1, 2008 and September 30, 2020 identifying 313 different miRNAs implicated in epigenetic regulation of EC. Overall, we identified a total of 148 miRNAs with decreased expression in EC, 140 miRNAs with increased expression in EC, and 22 miRNAs with discordant expression levels. The literature implicated different epigenetic phenomena including altered miRNA expression levels (miR-182, -230), changes in the methylation of miRNA loci (miR-34b, -129-2, -130a/b, -152, -200b, -625) and increased/decreased methylation of target genes (miR-30d,-191). This work provides an overview of all miRNAs reported to be involved in epigenetic regulation in EC including DNA methylation and RNA-associated silencing. These findings may contribute to novel strategies in diagnosis, risk assessment, and treatments aimed at miRNAs, their target genes or DNA methylation.

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Section: Discussionmentioning

confidence: 99%

MicroRNA as Epigenetic Modifiers in Endometrial Cancer: A Systematic Review

Favier

Rocher

Larsen

et al. 2021

Cancers

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“…Again, PORTEC-3 indicates that combined therapy leads to a statistically significant survival advantage for P53abn stage 1-3 [28]. Finally, note that the 2021 recommendations make a difference between P53abn with and without myometrial invasion [1]. Should molecular evaluation be performed preoperatively?…”

Section: Discussionmentioning

confidence: 99%

“…In January 2021 the European Society of Gynecological Oncology (ESGO), the European Society for Radiotherapy and Oncology (ESTRO), and the European Society of Pathology (ESP) published updated guidelines for risk group determination in endometrial cancer, integrating both molecular diagnostics and clinicopathologic variables, with the goal of improving patient treatment [1]. These molecular prognostic risk groups represent a revolutionary change in the management of women with endometrial cancer (EC) and will require a total reorientation of how these patients are diagnosed and treated.…”

Section: Introductionmentioning

confidence: 99%

Implementation of the 2021 molecular ESGO/ESTRO/ESP risk groups in endometrial cancer

Imboden

Nastic

Ghaderi

et al. 2021

Preprint

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Introduction In 2021, a joint ESGO/ESTRO/ESP committee updated their evidence-based guidelines for endometrial cancer, recommending a new risk grouping incorporating both clinicopathologic and molecular parameters. We applied the new risk grouping and compared the results to those of the prior 2016 clinicopathologic system. Materials and methods We classified molecularly a cohort of 604 women diagnosed with endometrial cancer using immunohistochemistry for TP53 and MMR proteins on a tissue microarray, as well as Sanger sequencing for POLE mutations. These results, combined with clinicopathologic data, allowed the patients to be risk grouped using both the new 2021 molecular/clinicopathologic parameters and the prior 2016 clinicopathologic system. In addition, clinical treatment and outcome data were collected from medical records. Results The application of the 2021 molecular markers shows Kaplan-Meier curves with a significant difference between the groups for all survival. Molecular classification under the 2021 guidelines revealed a total of 39 patients (39/594, 7%) with a change in risk group in relation to the 2016 classification system: the shift was alone due to either P53abn or POLEmut molecular marker. In order to ensure correct 2021 molecular risk classification, not all patients with endometrial cancer need a molecular diagnostic: 386 (65.0%) cases would need to be analyzed by TP53 IHC, only 44 (7.4%) by MMR IHC and 109 (18.4%) POLE sequencing reactions. Conclusion Application of the 2021 molecular risk groups is feasible and shows significant differences in survival. IHC for TP53 and MMR and applying POLE sequencing is only needed in selected

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“…We have received highest number of submissions nearly 538 articles, across the globe indicating acceptance of the journal by the oncology community. The articles published in IJSO well accepted by the accreditation bodies and the articles were cited during development of guidelines by ESGO/ESTRO/ESP guidelines for the management of patients with carcinoma Endometrium [3][4][5].…”

Section: Dear Friendsmentioning

confidence: 99%