Molecular profile is a strong predictor of the pattern of recurrence in patients with endometrial cancer (2025)

Aznar, A. L., Bebia, V., López-Gil, C., Villafranca-Magdalena, B., Salazar-Huayna, L., Castellvi, J., Colàs, E., Gil-Moreno, A. (2024). Molecular profile is a strong predictor of the pattern of recurrence in patients with endometrial cancer. International Journal of Gynecological Cancer, 34(5), 659-666. https://doi.org/10.1136/ijgc-2023-005165

Aznar, Ana Luzarraga ; Bebia, Vicente ; López-Gil, Carlos et al. / Molecular profile is a strong predictor of the pattern of recurrence in patients with endometrial cancer. In: International Journal of Gynecological Cancer. 2024 ; Vol. 34, Núm. 5. pàg. 659-666.

@article{75ba2c61bd7e4d2181679a739f9eadfb,

title = "Molecular profile is a strong predictor of the pattern of recurrence in patients with endometrial cancer",

abstract = "Objectives To investigate the pattern of first recurrence of disease in patients with endometrial cancer according to molecular classification, and to assess the independent role of molecular profiling in each type of failure. Methods Retrospective single-center study including patients diagnosed with endometrial cancer stage I–IVB (International Federation of Gynecology and Obstetrics 2009) between December 1994 and May 2022, who underwent primary surgical treatment and had a complete molecular profile. First recurrence was classified as isolated or multiple, and as vaginal, pelvic, peritoneal, nodal, and distant according to its location. The log-rank test and univariate and multivariate adjusted Cox regression models were used for comparison between groups. Results A total of 658 patients were included. Recurrence was observed in 122 patients (18.5%) with a recurrence rate of 12.4% among mismatch-repair deficient tumors, 14.5% among non-specific molecular profile, 2.1% among POLE-mutated, and 53.7% among p53-abnormal tumors. Recurrences were found to be isolated in 80 (65.6%) and multiple in 42 (34.4%) patients, with no differences in molecular subtype (p=0.92). Patients with p53-abnormal tumors had a recurrence mainly as distant (28.4%) and peritoneal (21.1%) disease, while patients with non-specific molecular profile tumors presented predominantly with distant failures (10.3%), and mismatch-repair deficient tumors with locoregional recurrences (9.4%). On multivariate analysis, p53-abnormal molecular profile was the only independent risk factor for peritoneal failure (OR=8.54, 95% CI 2.0 to 36.3). Vaginal recurrence was independently associated with p53-abnormal molecular profile (OR=6.51, 95% CI 1.1 to 37.4) and lymphovascular space invasion. p53-abnormal and non-specific molecular profiles were independent predictors for distant recurrence (OR=3.13, 95% CI 1.1 to 8.7 and OR=2.35, 95% CI 1.1 to 5.0, respectively), along with lymphovascular space invasion and high-grade tumors. Molecular profile was not independently associated with pelvic and nodal recurrences. Conclusions Endometrial cancer featured different patterns of recurrence depending on the molecular profile. p53-abnormal molecular profiling was the only independent risk factor for peritoneal relapse, while nonspecific molecular profile showed a strong association with distant failures.",

author = "Aznar, {Ana Luzarraga} and Vicente Bebia and Carlos L{\'o}pez-Gil and Beatriz Villafranca-Magdalena and Lourdes Salazar-Huayna and Josep Castellvi and Eva Col{\`a}s and Antonio Gil-Moreno and Silvia Cabrera",

note = "{\textcopyright} IGCS and ESGO 2024. No commercial re-use. See rights and permissions. Published by BMJ.",

year = "2024",

month = may,

day = "1",

doi = "10.1136/ijgc-2023-005165",

language = "English",

volume = "34",

pages = "659--666",

journal = "International Journal of Gynecological Cancer",

issn = "1048-891X",

publisher = "Wolters Kluwer",

number = "5",

}

Aznar, AL, Bebia, V, López-Gil, C, Villafranca-Magdalena, B, Salazar-Huayna, L, Castellvi, J, Colàs, E, Gil-Moreno, A 2024, 'Molecular profile is a strong predictor of the pattern of recurrence in patients with endometrial cancer', International Journal of Gynecological Cancer, vol. 34, núm. 5, pàg. 659-666. https://doi.org/10.1136/ijgc-2023-005165

Molecular profile is a strong predictor of the pattern of recurrence in patients with endometrial cancer. / Aznar, Ana Luzarraga; Bebia, Vicente; López-Gil, Carlos et al.
In: International Journal of Gynecological Cancer, Vol. 34, Núm. 5, 01.05.2024, pàg. 659-666.

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TY - JOUR

T1 - Molecular profile is a strong predictor of the pattern of recurrence in patients with endometrial cancer

AU - Aznar, Ana Luzarraga

AU - Bebia, Vicente

AU - López-Gil, Carlos

AU - Villafranca-Magdalena, Beatriz

AU - Salazar-Huayna, Lourdes

AU - Castellvi, Josep

AU - Colàs, Eva

AU - Gil-Moreno, Antonio

AU - Cabrera, Silvia

N1 - © IGCS and ESGO 2024. No commercial re-use. See rights and permissions. Published by BMJ.

PY - 2024/5/1

Y1 - 2024/5/1

N2 - Objectives To investigate the pattern of first recurrence of disease in patients with endometrial cancer according to molecular classification, and to assess the independent role of molecular profiling in each type of failure. Methods Retrospective single-center study including patients diagnosed with endometrial cancer stage I–IVB (International Federation of Gynecology and Obstetrics 2009) between December 1994 and May 2022, who underwent primary surgical treatment and had a complete molecular profile. First recurrence was classified as isolated or multiple, and as vaginal, pelvic, peritoneal, nodal, and distant according to its location. The log-rank test and univariate and multivariate adjusted Cox regression models were used for comparison between groups. Results A total of 658 patients were included. Recurrence was observed in 122 patients (18.5%) with a recurrence rate of 12.4% among mismatch-repair deficient tumors, 14.5% among non-specific molecular profile, 2.1% among POLE-mutated, and 53.7% among p53-abnormal tumors. Recurrences were found to be isolated in 80 (65.6%) and multiple in 42 (34.4%) patients, with no differences in molecular subtype (p=0.92). Patients with p53-abnormal tumors had a recurrence mainly as distant (28.4%) and peritoneal (21.1%) disease, while patients with non-specific molecular profile tumors presented predominantly with distant failures (10.3%), and mismatch-repair deficient tumors with locoregional recurrences (9.4%). On multivariate analysis, p53-abnormal molecular profile was the only independent risk factor for peritoneal failure (OR=8.54, 95% CI 2.0 to 36.3). Vaginal recurrence was independently associated with p53-abnormal molecular profile (OR=6.51, 95% CI 1.1 to 37.4) and lymphovascular space invasion. p53-abnormal and non-specific molecular profiles were independent predictors for distant recurrence (OR=3.13, 95% CI 1.1 to 8.7 and OR=2.35, 95% CI 1.1 to 5.0, respectively), along with lymphovascular space invasion and high-grade tumors. Molecular profile was not independently associated with pelvic and nodal recurrences. Conclusions Endometrial cancer featured different patterns of recurrence depending on the molecular profile. p53-abnormal molecular profiling was the only independent risk factor for peritoneal relapse, while nonspecific molecular profile showed a strong association with distant failures.

AB - Objectives To investigate the pattern of first recurrence of disease in patients with endometrial cancer according to molecular classification, and to assess the independent role of molecular profiling in each type of failure. Methods Retrospective single-center study including patients diagnosed with endometrial cancer stage I–IVB (International Federation of Gynecology and Obstetrics 2009) between December 1994 and May 2022, who underwent primary surgical treatment and had a complete molecular profile. First recurrence was classified as isolated or multiple, and as vaginal, pelvic, peritoneal, nodal, and distant according to its location. The log-rank test and univariate and multivariate adjusted Cox regression models were used for comparison between groups. Results A total of 658 patients were included. Recurrence was observed in 122 patients (18.5%) with a recurrence rate of 12.4% among mismatch-repair deficient tumors, 14.5% among non-specific molecular profile, 2.1% among POLE-mutated, and 53.7% among p53-abnormal tumors. Recurrences were found to be isolated in 80 (65.6%) and multiple in 42 (34.4%) patients, with no differences in molecular subtype (p=0.92). Patients with p53-abnormal tumors had a recurrence mainly as distant (28.4%) and peritoneal (21.1%) disease, while patients with non-specific molecular profile tumors presented predominantly with distant failures (10.3%), and mismatch-repair deficient tumors with locoregional recurrences (9.4%). On multivariate analysis, p53-abnormal molecular profile was the only independent risk factor for peritoneal failure (OR=8.54, 95% CI 2.0 to 36.3). Vaginal recurrence was independently associated with p53-abnormal molecular profile (OR=6.51, 95% CI 1.1 to 37.4) and lymphovascular space invasion. p53-abnormal and non-specific molecular profiles were independent predictors for distant recurrence (OR=3.13, 95% CI 1.1 to 8.7 and OR=2.35, 95% CI 1.1 to 5.0, respectively), along with lymphovascular space invasion and high-grade tumors. Molecular profile was not independently associated with pelvic and nodal recurrences. Conclusions Endometrial cancer featured different patterns of recurrence depending on the molecular profile. p53-abnormal molecular profiling was the only independent risk factor for peritoneal relapse, while nonspecific molecular profile showed a strong association with distant failures.

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UR - https://www.mendeley.com/catalogue/51bcba6c-dc07-38b9-84ac-24e275de3a68/

U2 - 10.1136/ijgc-2023-005165

DO - 10.1136/ijgc-2023-005165

M3 - Article

C2 - 38378696

AN - SCOPUS:85185912238

SN - 1048-891X

VL - 34

SP - 659

EP - 666

JO - International Journal of Gynecological Cancer

JF - International Journal of Gynecological Cancer

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Aznar AL, Bebia V, López-Gil C, Villafranca-Magdalena B, Salazar-Huayna L, Castellvi J et al. Molecular profile is a strong predictor of the pattern of recurrence in patients with endometrial cancer. International Journal of Gynecological Cancer. 2024 maig 1;34(5):659-666. doi: 10.1136/ijgc-2023-005165