Prognosis stratification tools in early-stage endometrial cancer: could we improve their accuracy?

There are three prognostic stratification tools used for endometrial cancer: ESMO-ESGO-ESTRO 2016, ProMisE, and ESGO-ESTRO-ESP 2020. However, these methods are not sufficiently accurate to address prognosis. The aim of this study was to investigate whether the integration of molecular classification...

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Detalles Bibliográficos
Autores: Ramon-Patino, Jorge Luis, Ruz-Caracuel, Ignacio, Heredia-Soto, Victoria, García de la Calle, Luis Eduardo, Zagidullin, Bulat, Wang, Yinyin, Berjón, Alberto, López-Janeiro, Álvaro, Miguel, María, Escudero, Javier, Gallego, Alejandro, Castelo Fernández, Beatriz, Yébenes, Laura, Hernández Gutiérrez, María Alicia, Feliú Batlle, Jaime, Pelaez-García, Alberto, Tang, Jing, Hardisson Hernáez, David Alonso, Mendiola, Marta, Redondo Sánchez, Andrés
Tipo de recurso: artículo
Fecha de publicación:2022
País:España
Institución:Universidad Autónoma de Madrid
Repositorio:Biblos-e Archivo. Repositorio Institucional de la UAM
Idioma:inglés
OAI Identifier:oai:repositorio.uam.es:10486/707575
Acceso en línea:http://hdl.handle.net/10486/707575
https://dx.doi.org/10.3390/cancers14040912
Access Level:acceso abierto
Palabra clave:Biomarkers
CTNNB1
Endometrial cancer
Prognosis
Risk assessment
Medicina
Descripción
Sumario:There are three prognostic stratification tools used for endometrial cancer: ESMO-ESGO-ESTRO 2016, ProMisE, and ESGO-ESTRO-ESP 2020. However, these methods are not sufficiently accurate to address prognosis. The aim of this study was to investigate whether the integration of molecular classification and other biomarkers could be used to improve the prognosis stratification in early-stage endometrial cancer. Relapse-free and overall survival of each classifier were analyzed, and the c-index was employed to assess accuracy. Other biomarkers were explored to improve the precision of risk classifiers. We analyzed 293 patients. A comparison between the three classifiers showed an improved accuracy in ESGO-ESTRO-ESP 2020 when RFS was evaluated (c-index = 0.78), although we did not find broad differences between intermediate prognostic groups. Prognosis of these patients was better stratified with the incorporation of CTNNB1 status to the 2020 classifier (c-index 0.81), with statistically significant and clinically relevant differences in 5-year RFS: 93.9% for low risk, 79.1% for intermediate merged group/CTNNB1 wild type, and 42.7% for high risk (includ-ing patients with CTNNB1 mutation). The incorporation of molecular classification in risk stratification resulted in better discriminatory capability, which could be improved even further with the addition of CTNNB1 mutational evaluation

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