Siegenthaler, Franziska; Epstein, Elisabeth; Büchi, Carol A; Gmür, Andrea; Saner, Flurina A C M; Rau, Tilman T; Carlson, Joseph W; Mueller, Michael D; Imboden, Sara (2023). Prognostic value of lymphovascular space invasion according to the molecular subgroups in endometrial cancer. International journal of gynecological cancer, 33(11), pp. 1702-1707. BMJ Publishing Group Ltd 10.1136/ijgc-2023-004606
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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 POLEmut (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 POLEmut, 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.
Item Type: |
Journal Article (Original Article) |
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Division/Institute: |
04 Faculty of Medicine > Department of Gynaecology, Paediatrics and Endocrinology (DFKE) > Clinic of Gynaecology 04 Faculty of Medicine > Service Sector > Institute of Pathology > Clinical Pathology 04 Faculty of Medicine > Service Sector > Institute of Pathology |
UniBE Contributor: |
Siegenthaler, Franziska Anna, Büchi, Carol Anne, Gmür, Andrea, Saner, Flurina Anna-Carina Maria, Rau, Tilman, Mueller, Michael, Imboden, Sara |
Subjects: |
600 Technology > 610 Medicine & health 500 Science > 570 Life sciences; biology |
ISSN: |
1525-1438 |
Publisher: |
BMJ Publishing Group Ltd |
Language: |
English |
Submitter: |
Pubmed Import |
Date Deposited: |
05 Sep 2023 10:35 |
Last Modified: |
08 Nov 2023 00:14 |
Publisher DOI: |
10.1136/ijgc-2023-004606 |
PubMed ID: |
37666529 |
Uncontrolled Keywords: |
lymphatic metastasis lymphatic vessels pathology uterine cancer |
BORIS DOI: |
10.48350/186038 |
URI: |
https://boris.unibe.ch/id/eprint/186038 |
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