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dc.contributor.authorVrede, S. W.
dc.contributor.authorVan Weelden, Willem Jan
dc.contributor.authorVisser, N. C. M.
dc.contributor.authorBulten, Johan
dc.contributor.authorvan der Putten, Louis J. M.
dc.contributor.authorvan de Vijver, Koen
dc.contributor.authorSantacana, M.
dc.contributor.authorColas, L.
dc.contributor.authorGil-Moreno, Antonio
dc.contributor.authorMoiola, Cristian P.
dc.contributor.authorMancebo, Gemma
dc.contributor.authorKrakstad, Camilla
dc.contributor.authorTrovik, Jone
dc.contributor.authorHaldorsen, Ingfrid S.
dc.contributor.authorHuvila, Jutta
dc.contributor.authorKoskas, Martin
dc.contributor.authorWeinberger, Vit
dc.contributor.authorBednarikova, M.
dc.contributor.authorHausnerova, J.
dc.contributor.authorvan der Wurff, Anneke A. M.
dc.contributor.authorMatias-Guiu, Xavier
dc.contributor.authorAmant, Frederic
dc.contributor.authorENITEC Consortium
dc.contributor.authorSnijders, Marc P. L. M.
dc.contributor.authorKüsters-Vandevelde, Heidi V. N
dc.contributor.authorReijnen, Casper
dc.contributor.authorPijnenborg, Johanna M. A.
dc.description.abstractObjective Pre-operative immunohistochemical (IHC) biomarkers are not incorporated in endometrial cancer (EC) risk classification. We aim to investigate the added prognostic relevance of IHC biomarkers to the ESMO-ESGO-ESTRO risk classification and lymph node (LN) status in EC. Methods Retrospective multicenter study within the European Network for Individualized Treatment of Endometrial Cancer (ENITEC), analyzing pre-operative IHC expression of p53, L1 cell-adhesion molecule (L1CAM), estrogen receptor (ER) and progesterone receptor (PR), and relate to ESMO-ESGO-ESTRO risk groups, LN status and outcome. Results A total of 763 EC patients were included with a median follow-up of 5.5-years. Abnormal IHC expression was present for p53 in 112 (14.7%), L1CAM in 79 (10.4%), ER- in 76 (10.0%), and PR- in 138 (18.1%) patients. Abnormal expression of p53/L1CAM/ER/PR was significantly related with higher risk classification groups, and combined associated with the worst outcome within the ‘high and advanced/metastatic’ risk group. In multivariate analysis p53-abn, ER/PR- and ESMO-ESGO-ESTRO ‘high and advanced/metastatic’ were independently associated with reduced disease-specific survival (DSS). Patients with abnormal IHC expression and lymph node metastasis (LNM) had the worst outcome. Patients with LNM and normal IHC expression had comparable outcome with patients without LNM and abnormal IHC expression. Conclusion The use of pre-operative IHC biomarkers has important prognostic relevance in addition to the ESMO-ESGO-ESTRO risk classification and in addition to LN status. For daily clinical practice, p53/L1CAM/ER/PR expression could serve as indicator for surgical staging and refine selective adjuvant treatment by incorporation into the ESMO-ESGO-ESTRO risk classification.ca_ES
dc.relation.isformatofReproducció del document publicat a
dc.relation.ispartofGynecologic Oncology, 2021, vol. 161, núm. 3, p. 787-794ca_ES
dc.rightscc-by (c) Vrede et al., 2021ca_ES
dc.subjectEndometrial carcinomaca_ES
dc.subjectLymph node metastasisca_ES
dc.titleImmunohistochemical biomarkers are prognostic relevant in addition to the ESMO-ESGO-ESTRO risk classification in endometrial cancerca_ES

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