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

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 o...

Descripción completa

Detalles Bibliográficos
Autores principales: 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
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10646877/
https://www.ncbi.nlm.nih.gov/pubmed/37666529
http://dx.doi.org/10.1136/ijgc-2023-004606
_version_ 1785147468578553856
author 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
author_facet 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
author_sort Siegenthaler, Franziska
collection PubMed
description 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.
format Online
Article
Text
id pubmed-10646877
institution National Center for Biotechnology Information
language English
publishDate 2023
publisher BMJ Publishing Group
record_format MEDLINE/PubMed
spelling pubmed-106468772023-11-15 Prognostic value of lymphovascular space invasion according to the molecular subgroups in endometrial cancer 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 Int J Gynecol Cancer Original Research 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. BMJ Publishing Group 2023-11 2023-09-04 /pmc/articles/PMC10646877/ /pubmed/37666529 http://dx.doi.org/10.1136/ijgc-2023-004606 Text en © IGCS and ESGO 2023. Re-use permitted under CC BY-NC. No commercial re-use. Published by BMJ. https://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, an indication of whether changes were made, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) .
spellingShingle Original Research
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
Prognostic value of lymphovascular space invasion according to the molecular subgroups in endometrial cancer
title Prognostic value of lymphovascular space invasion according to the molecular subgroups in endometrial cancer
title_full Prognostic value of lymphovascular space invasion according to the molecular subgroups in endometrial cancer
title_fullStr Prognostic value of lymphovascular space invasion according to the molecular subgroups in endometrial cancer
title_full_unstemmed Prognostic value of lymphovascular space invasion according to the molecular subgroups in endometrial cancer
title_short Prognostic value of lymphovascular space invasion according to the molecular subgroups in endometrial cancer
title_sort prognostic value of lymphovascular space invasion according to the molecular subgroups in endometrial cancer
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10646877/
https://www.ncbi.nlm.nih.gov/pubmed/37666529
http://dx.doi.org/10.1136/ijgc-2023-004606
work_keys_str_mv AT siegenthalerfranziska prognosticvalueoflymphovascularspaceinvasionaccordingtothemolecularsubgroupsinendometrialcancer
AT epsteinelisabeth prognosticvalueoflymphovascularspaceinvasionaccordingtothemolecularsubgroupsinendometrialcancer
AT buchicarola prognosticvalueoflymphovascularspaceinvasionaccordingtothemolecularsubgroupsinendometrialcancer
AT gmurandrea prognosticvalueoflymphovascularspaceinvasionaccordingtothemolecularsubgroupsinendometrialcancer
AT sanerflurinaacm prognosticvalueoflymphovascularspaceinvasionaccordingtothemolecularsubgroupsinendometrialcancer
AT rautilmant prognosticvalueoflymphovascularspaceinvasionaccordingtothemolecularsubgroupsinendometrialcancer
AT carlsonjosephw prognosticvalueoflymphovascularspaceinvasionaccordingtothemolecularsubgroupsinendometrialcancer
AT muellermichaeld prognosticvalueoflymphovascularspaceinvasionaccordingtothemolecularsubgroupsinendometrialcancer
AT imbodensara prognosticvalueoflymphovascularspaceinvasionaccordingtothemolecularsubgroupsinendometrialcancer