Prognostic value of lymphovascular space invasion according to the molecular subgroups in endometrial cancer.

Autor:	Siegenthaler F; Department of Obstetrics and Gynecology, University Hospital Bern and Univeristy of Bern, Bern, Switzerland franziska.siegenthaler@insel.ch., Epstein E; Department of Clinical Science and Education, Södersjukhuset (KI-SÖS), Stockholm, Sweden., Büchi CA; Department of Obstetrics and Gynecology, University Hospital Bern and Univeristy of Bern, Bern, Switzerland., Gmür A; Department of Obstetrics and Gynecology, University Hospital Bern and Univeristy of Bern, Bern, Switzerland., Saner FACM; Department of Obstetrics and Gynecology, University Hospital Bern and Univeristy of Bern, Bern, Switzerland., Rau TT; Institue for Tissue Medicine and Pathology, University of Bern, Bern, Switzerland., Carlson JW; Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden., Mueller MD; Department of Obstetrics and Gynecology, University Hospital Bern and Univeristy of Bern, Bern, Switzerland., Imboden S; Department of Obstetrics and Gynecology, University Hospital Bern and Univeristy of Bern, Bern, Switzerland.
Jazyk:	angličtina
Zdroj:	International journal of gynecological cancer : official journal of the International Gynecological Cancer Society [Int J Gynecol Cancer] 2023 Nov 06; Vol. 33 (11), pp. 1702-1707. Date of Electronic Publication: 2023 Nov 06.
DOI:	10.1136/ijgc-2023-004606
Abstrakt:	Objective: Lymphovascular space invasion (LVSI) is a known prognostic factor for oncological outcome in endometrial cancer patients. However, little is known about the prognostic value of LVSI among the different molecular subgroups. The aim of this study was to determine the prognostic dependence of LVSI from the molecular signature. Methods: This study included endometrial cancer patients who underwent primary surgical treatment between February 2004 and February 2016 at the Karolinska University Hospital, Sweden and the Bern University Hospital, Switzerland (KImBer cohort). All cases had complete molecular analysis performed on the primary tumor according to the WHO Classification of Tumors, 5th edition. LVSI was reviewed by reference pathologists for all pathology slides. Results: A total of 589 endometrial cancer patients were included in this study, consisting of 40 POLE mut (polymerase epsilon ultramutated), 198 MMRd (mismatch repair deficient), 83 p53abn (p53 abnormal), and 268 NSMP (non-specific molecular profile) cases. Altogether, 17% of tumors showed LVSI: 25% of the POLE mut, 19% of the MMRd, 30% of the p53abn, and 10% of the NSMP cases. There was a significant correlation of LVSI with lymph node metastasis in the entire study cohort (p<0.001), remaining significant in the MMRd (p=0.020), p53abn (p<0.001), and NSMP (p<0.001) subgroups. Mean follow-up was 89 months (95% CI 86 to 93). The presence of LVSI significantly decreased recurrence-free survival among patients with MMRd, p53abn, and NSMP endometrial cancer, and overall survival in patients with p53abn and NSMP tumors. In patients with NSMP endometrial cancer, evidence of substantial LVSI remained a significant independent predictor of recurrence in multivariable Cox regression analysis including tumor stage and grade (HR 7.5, 95% CI 2.2 to 25.5, p=o.001). Conclusion: The presence of LVSI was associated with recurrence in each subgroup of patients with MMRd, p53abn, and NSMP endometrial cancer, and LVSI remained an independent predictor of recurrence in NSMP endometrial cancer patients. Competing Interests: Competing interests: None declared. (© IGCS and ESGO 2023. Re-use permitted under CC BY-NC. No commercial re-use. Published by BMJ.)
Databáze:	MEDLINE
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