Prognostic Effect of Mismatch Repair Status in Early-Stage Endometrial Cancer Treated With Adjuvant Radiation: A Multi-institutional Analysis.

Autor:	Hathout L; Department of Radiation Oncology, Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey. Electronic address: lh547@cinj.rutgers.edu., Sherwani ZK; Department of Radiation Oncology, Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey., Alegun J; Department of Radiation Oncology, Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey., Ohri N; Department of Radiation Oncology, Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey., Fields EC; Department of Radiation Oncology, Virginia Commonwealth University Health System, Massey Cancer Center, Richmond, Virginia., Shah S; Department of Radiation Oncology, Virginia Commonwealth University Health System, Massey Cancer Center, Richmond, Virginia., Beriwal S; Allegheny Health Network, Pittsburgh, Pennsylvania., Horne ZD; Allegheny Health Network, Pittsburgh, Pennsylvania., Kidd EA; Department of Radiation Oncology, Stanford University School of Medicine, Stanford, California., Leung EW; Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada., Song J; Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada., Taunk NK; Department of Radiation Oncology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania., Chino J; Department of Radiation Oncology, Duke University Medical Center, Durham, North Carolina., Huang C; Department of Radiation Oncology, Duke University Medical Center, Durham, North Carolina., Russo AL; Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts., Dyer M; Department of Radiation Oncology, Brigham and Women's Hospital and Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts., Li J; Department of Therapeutic Radiology, Yale School of Medicine, New Haven, Connecticut., Albuquerque KV; Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, Texas., Damast S; Department of Therapeutic Radiology, Yale School of Medicine, New Haven, Connecticut.
Jazyk:	angličtina
Zdroj:	International journal of radiation oncology, biology, physics [Int J Radiat Oncol Biol Phys] 2024 Jul 15; Vol. 119 (4), pp. 1158-1165. Date of Electronic Publication: 2024 Jan 20.
DOI:	10.1016/j.ijrobp.2024.01.203
Abstrakt:	Purpose: The aim of this work was to report the effect of mismatch repair (MMR) status on outcomes of patients with stage I-II endometrioid endometrial adenocarcinoma (EEC) who receive adjuvant radiation therapy. Methods and Materials: This is a multi-institutional retrospective cohort study across 11 institutions in North America. Patients with known MMR status and stage I-II EEC status postsurgical staging were included. Overall survival (OS) and recurrence-free survival (RFS) rates were estimated via the Kaplan-Meier method. Univariable and multivariable analyses were performed via Cox proportional hazard models for RFS and OS. Statistical analyses were conducted using SPSS version 27. Results: In total, 744 patients with a median age at diagnosis of 65 years (IQR, 58-71) were included. Most patients were White (69.4%) and had Federation of Obstetrics and Gynecology 2009 stage I (84%) and Federation of Obstetrics and Gynecology grade 1 to 2 (73%). MMR deficiency was reported in 234 patients (31.5%), whereas 510 patients (68.5%) had preserved MMR. External beam radiation therapy with or without vaginal brachytherapy was delivered to 186 patients (25%), whereas 558 patients (75%) received vaginal brachytherapy alone. At a median follow-up of 43.5 months, the estimated crude OS and RFS rates for the entire cohort were 92.5% and 84%, respectively. MMR status was significantly correlated with RFS. RFS was inferior for MMR deficiency compared with preserved MMR (74.3% vs 88.6%, P < .001). However, no difference in OS was seen (90.8% vs 93.2%, P = .5). On multivariable analysis, MMR deficiency status was associated with worse RFS (hazard ratio, 1.86; P = .001) but not OS. Conclusions: MMR status was independently associated with RFS but not OS in patients with early-stage EEC who were treated with adjuvant radiation therapy. These findings suggest that differential approaches to surveillance and/or treatment based on MMR status could be warranted. (Copyright © 2024 Elsevier Inc. All rights reserved.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu