Triple negative endometrial cancer: Incidence and prognosis in a monoinstitutional series of 220�patients

Abstract

Endometrial cancer (EC) represents the most frequently occuring gynecological tumor worldwide. The aim of the present study was to estimate the prognostic value of triple negative phenotype (TNP) in EC, and any associations with to pathological and clinical characteristics. The present study includes 220 cases of patients with EC who underwent to surgery at the Guglielmo da Saliceto Hospital of Piacenza (Italy) and the expressions of estrogen receptor (ER), progesterone receptor (PR) and oncoprotein c-erbB-2 (HER2) expression were examined. Pearson's Chi-square and Fisher's exact test were used to evaluate the association of TNP cases with variables associated with a worse prognosis. Progression-free survival (PFS) and overall survival (OS) were analyzed with Kaplan-Meier curves. A total of 26 patients (12%) had a TNP, and these cases had a higher percentage of high-risk histology, an advanced stage of disease at the time of diagnosis, with shorter PFS and OS when compared to non-TNP. The present study confirmed that TNP represents prognostic significance in EC.

Triple negative phenomenon in endometrial cancer: recognition criteria and impact on survival

“…Each study was conducted on a different continent. In a study covering the European population, the percentage of endometrial cancers with TNP was 12% [18]. In one publication, the percentage of endometrial cancers showing TNP was not determined [15].…”

“…The results classified as 1+ or 0 were considered negative, whereas 1+ meant strong or weak expression of less than10% of all cells. The absence of receptor expression was defined as 0 [14,16,18]. It should be noted that the results of the presented score differ greatly when converted to the H-Score.…”

“…In the case of the H-Score < 50 it reached 10.94%, while according to the H-Score < 75 it was even higher at 15.09%. If the criteria used most often in the literature were adopted, in the population under study the percentage of endometrial cancers with TNP would range between 5.24 and 8.61% [14,16,18]. When adopting the TNP diagnosis criteria proposed by Voss et al, the percentage of triple negative endometrial cancers would amount to 37.09%.…”

“…They were at a more severe clinical stage at the time of diagnosis and were accompanied by the presence of lymph node metastases, deeper uterine infiltration and an unfavourable histopathological type, i.e., clear-cell or serous carcinoma. There is a limited number of reports of triple negative endometrial cancer [14][15][16][17][18][19].…”

Elevated CA-125 Level and ER-Negative as Prognostic Factors for Ovarian Metastasis in Patients with Endometrial Cancer: A Retrospective Cohort Study

“…Low ER immunohistochemical staining was reported to be significantly correlated with an aggressive clinicopathologic phenotype and reduced survival in all endometrial cancer patient cohorts studied [ 23 – 26 ]. On the other hand, double-negative hormone receptor status in endometrial cancer preoperative curettage histology independently predicted lymph node metastasis and poor prognosis in a prospective multicenter study [ 16 ].…”