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The prognosis of endometrial cancers stratified with conventional risk factors and modified molecular classification

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Title: The prognosis of endometrial cancers stratified with conventional risk factors and modified molecular classification
Authors: Yamazaki, Hiroyuki Browse this author
Asano, Hiroshi Browse this author
Hatanaka, Kanako C. Browse this author
Matsuoka, Ryosuke Browse this author
Konno, Yosuke Browse this author →KAKEN DB
Matsuno, Yoshihiro Browse this author
Hatanaka, Yutaka Browse this author →KAKEN DB
Watari, Hidemichi Browse this author →KAKEN DB
Keywords: adjuvant chemotherapy
endometrial cancer
lymphadenectomy
molecular classification
survival
Issue Date: Sep-2022
Publisher: John Wiley & Sons
Journal Title: Cancer science
Volume: 113
Issue: 9
Start Page: 3134
End Page: 3147
Publisher DOI: 10.1111/cas.15460
Abstract: This study aimed to validate the Proactive Molecular Risk Classifier for Endometrial Cancer, a modified version of The Cancer Genome Atlas, using data from 184 patients with endometrial cancer (median age: 57.5 years; median follow-up period: 109 months) who had undergone radical surgery (including systemic lymphadenectomy) and subsequent adjuvant chemotherapy (patients with intermediate or high recurrence risk) from 2003 to 2015. Tissue microarrays were prepared from surgical specimens and classified using the conventional clinical risk classifier. Immunohistochemistry was used to detect mismatch repair proteins, L1 cell adhesion molecule, and p53. Direct sequencing was used to identify hotspot mutations in the polymerase-epsilon gene. Forty-five patients were identified as having high L1 cell adhesion molecule expression, 41 as low risk, 34 as mismatch repair-deficient, 13 as polymerase-epsilon gene-mutated, five as having abnormal p53, and 46 as other. Patients were stratified into significantly different prognostic groups (p < 0.0001): favorable (low risk and polymerase-epsilon gene-mutated), intermediate (mismatch repair-deficient and other), and unfavorable (high L1 cell adhesion molecule expression and abnormal p53) with 5-year disease-specific survival rates of 100%, 93.8%, and 75.1%, respectively (Kaplan-Meier method). The combination of conventional recurrent risk classification, sequencing for polymerase-epsilon gene mutations and immunohistochemistry for L1 cell adhesion molecule, p53, and mismatch repair proteins can be used to determine the prognoses of patients with endometrial cancer.
Type: article
URI: http://hdl.handle.net/2115/86787
Appears in Collections:北海道大学病院 (Hokkaido University Hospital) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)

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