Uterine serous carcinoma

Bogani, Giorgio; Ray‐Coquard, Isabelle; Concin, Nicole; Ngoi, Natalie; Morice, Philippe; Enomoto, Takayuki; Takehara, Kazuhiro; Denys, Hannelore; Nout, Remi A.; Lorusso, Domenica; Vaughan, Michelle; Bini, Marta; Takano, Masashi; Provencher, Diane; Indini, Alice; Sagae, Satoru; Wimberger, Pauline; Póka, Ròbert; Segev, Yakir; Kim, Se Ik; Reis, Francisco José Cândido dos; Lopez, Salvatore; Mariani, Andrea; Leitao, Mario M.; Raspagliesi, Francesco; Panici, P. Benedetti; Donato, Violante Di; Muzii, Ludovico; Colombo, Nicoletta; Scambia, Giovanni; Pignata, Sandro; Monk, Bradley J.

doi:10.1016/j.ygyno.2021.04.029

Cited by 76 publications

(65 citation statements)

References 57 publications

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“…PPP2R1A mutations occur in type I EC, but at much lower frequencies (2.5%–6.9%) [ 24 ]. As expected, the PPP2R1A mutation rate was higher in serous type EC samples than in endometrioid EC samples in our study, which is consistent with findings of previous studies [ 25 26 ]. However, a significantly higher mutation rate of PPP2R1A was detected in stage III/IV EC samples than in stage I EC samples in our study, which is a novel finding.…”

Section: Discussionsupporting

confidence: 93%

Genomic landscape of advanced endometrial cancer analyzed by targeted next-generation sequencing and the cancer genome atlas (TCGA) dataset

et al. 2022

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Objective Recent studies have detailed the genomic landscape of endometrial cancer (EC); however, no study has focused on genetic alterations in advanced EC. We performed genomic profiling of patients with advanced EC using targeted next-generation sequencing (NGS). Methods Archival tissue samples from 21 patients diagnosed with stage III and IV EC were obtained and subjected to NGS. Our data and the cancer genome atlas dataset were combined, and somatic mutation patterns were analyzed and compared according to the stage and histological type. Additionally, survival effects of specific mutated genes were analyzed. Results Somatic mutation patterns of 38 genes were identified in 263 EC samples, and the most commonly mutated genes were PTEN and PIK3CA . PTEN was the most common in endometrioid histology, while PPP2R1A was the most commonly mutated gene in serous histology. The mutation rates of PPP2R1A and TP53 were significantly higher in advanced EC sample than in stage I samples (22.5% vs. 4.3% [p<0.001] and 8.4% vs. 1.4% [p=0.021], respectively). Survival analysis of the total population and endometrioid subgroup revealed that patients with PPP2R1A mutations had significantly shorter survival than did those without mutations (p=0.005 and p<0.001, respectively). Conclusion PPP2R1A mutations might have a role in dismal prognosis of advanced EC.

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Section: Discussionsupporting

confidence: 93%

Genomic landscape of advanced endometrial cancer analyzed by targeted next-generation sequencing and the cancer genome atlas (TCGA) dataset

et al. 2022

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“…Indeed, the review confirms that accumulating data support the safety and effectiveness of SLN mapping for apparent early-stage uterine serous carcinoma. 18 A series published in 2017 compared survival of patients with SLN mapping versus complete lymphadenectomy and showed no difference in survival, suggesting that SLN alone does not appear to compromise prognosis in uterine serous carcinoma. 19 Lastly, in a recent study published by Jegatheeswaran et al, 36.6% of patients with high-grade endometrial carcinoma had complete surgical staging including para-aortic lymph node sampling and omentectomy but 50.1% had only SLN mapping and pelvic lymphadenectomy, indicating a trend towards omitting para-aortic lymphadenectomy and omental biopsy in high-grade uterine neoplasia.…”

Section: Results In the Context Of Published Literaturementioning

confidence: 99%

High-grade endometrial carcinoma limited to the endometrium or a polyp: is adjuvant treatment necessary?

Nantel

Renaud

Grégoire

et al. 2021

Int J Gynecol Cancer

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ObjectiveHigh-grade endometrial carcinoma limited to the endometrium or a polyp is a rare clinical entity. Currently there is no consensus on standard treatment. Thus, the goal of this study was to evaluate the clinical outcomes of patients with type II endometrial carcinoma without myometrial infiltration or limited to a polyp.MethodsWe retrospectively identified type II endometrial carcinoma (FIGO endometrioid grade 3, serous, clear cell, mixed and carcinosarcoma) with spread limited to the endometrium or a polyp from April 2013 to November 2017. Medical records were reviewed for the following information: age at diagnosis, patient characteristics, type of surgery, histology, stage according to FIGO 2009 classification, adjuvant treatments, and site of recurrence. Descriptive statistics and the Kaplan–Meier estimate were used for analysis.ResultsA total of 25 patients with a type II stage IA adenocarcinoma were included. All were surgically staged with total hysterectomy, salpingo-oophorectomy, and lymph nodes assessment. The median age at diagnosis was 69 years. All patients had either disease limited to the endometrium (60%) or a polyp (40%). Only four patients had lymphovascular space invasion (16%). The median follow-up was 44 (range 2–67) months. Six patients (24%) received vault brachytherapy only and all others received no adjuvant treatment after surgery (n=19, 76%). Three patients (12%) experienced recurrences at 15, 21, and 55 months after surgery. Following systemic treatment all are alive and disease-free. The 3-year progression-free survival and overall survival were 91% and 100%, respectively.ConclusionExpectant management with surveillance alone following surgery appears to be safe for patients with high-grade endometrial carcinoma limited to a polyp or the endometrium without myometrial invasion.

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“…This is especially true in recognizing serous EC. In these instances based on the molecular characteristics such as TP53 mutations 20 , integrated molecular evaluation could potentially enable individualized therapy already in the primary surgical setting.…”

Section: Discussionmentioning

confidence: 99%

Pre-treatment risk assessment of women with endometrial cancer: differences in outcomes of molecular and clinical classifications in the Slovenian patient cohort

Knez

Sobočan

Belak

et al. 2021

Radiology and Oncology

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Background The aim of this study was to evaluate changes in prognostic risk profiles of women with endometrial cancer by comparing the clinical risk assessment with the integrated molecular risk assessment profiling. Patients and methods This prospective study recruited patients with biopsy proven endometrial cancer treated at the University Medical Centre Maribor between January 2020 to February 2021. Patient clinical data was assessed and categorized according to the currently valid European Society of Gynaecological Oncology, European SocieTy for Radiotherapy and Oncology, and European Society of Pathology (ESGO/ESTRO/ESP) guidelines on endometrial cancer. Molecular tumour characterization included determination of exonuclease domain of DNA polymerase-epsilon (POLE) mutational status by Sanger sequencing and imunohistochemical specimen evaluation on the presence of mismatch repair deficiencies (MMRd) and p53 abnormalities (p53abn). Results Fourty-five women were included in the study. Twenty-two tumours were of non-specific mutational profile (NSMP) (56.4%), 13 were classified as MMRd (33.3%), 3 were classified as p53abn (7.7%) and 1 was classified as POLE mutated (2.6%). Six tumours (15.4%) had multiple molecular classifiers, these were studied separately and were not included in the risk assessment. The clinical risk-assessment classified 21 women (53.8%) as low-risk, 5 women (12.8%) as intermediate risk, 2 women as high-intermediate risk (5.1%), 10 women (25.6%) as high risk and 1 patient as advanced metastatic (2.6%). The integrated molecular classification changed risk for 4 women (10.3%). Conclusions Integrated molecular risk improves personalized risk assessment in endometrial cancer and could potentially improve therapeutic precision. Further molecular stratification with biomarkers is especially needed in the NSMP group to improve personalized risk-assessment.

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Uterine serous carcinoma

Cited by 76 publications

References 57 publications

Genomic landscape of advanced endometrial cancer analyzed by targeted next-generation sequencing and the cancer genome atlas (TCGA) dataset

Genomic landscape of advanced endometrial cancer analyzed by targeted next-generation sequencing and the cancer genome atlas (TCGA) dataset

High-grade endometrial carcinoma limited to the endometrium or a polyp: is adjuvant treatment necessary?

Pre-treatment risk assessment of women with endometrial cancer: differences in outcomes of molecular and clinical classifications in the Slovenian patient cohort

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