PDF(Pubmed)
Abstract：
No prospective study has validated molecular classification to guide adjuvant treatment in endometrial cancer (EC), and not even retrospective data are present for patients with morphological low-risk EC. We conducted a retrospective, multicenter, observational study including 370 patients with low-risk endometrioid EC to evaluate the incidence and prognostic role of p53 abnormal expression (p53abn) in this specific subgroup. Among 370 patients, 18 had abnormal expressions of p53 (4.9%). In 13 out of 370 patients (3.6%), recurrences were observed and two were p53abn. When adjusting for median follow-up time, the odds ratio (OR) for recurrence among those with p53abn versus p53 wild type (p53wt) was 5.23-CI 95% 0.98-27.95, p = 0.053. The most common site of recurrence was the vaginal cuff (46.2%). One recurrence occurred within the first year of follow-up, and the patient exhibited p53abn. Both 1-year and 2-year DFS rates were 94.4% and 100% in the p53abn and p53wt groups, respectively. One patient died from the disease and comprised p53wt. No difference in OS was registered between the two groups; the median OS was 21.9 months (16.4-30.1). Larger multicenter studies are needed to tailor the treatment of low-risk EC patients with p53abn. Performing molecular classification on all EC patients might be cost-effective, and despite the limits of our relatively small sample, p53abn patients seem to be at greater risk of recurrence, especially locally and after two years since diagnosis.
摘要：
没有前瞻性研究验证分子分类来指导子宫内膜癌（EC）的辅助治疗，甚至没有形态学低危EC患者的回顾性数据。我们做了一个回顾,多中心，纳入370例低危子宫内膜样EC患者的观察性研究，以评估p53异常表达（p53abn）在该特定亚组中的发生率和预后作用。在370名患者中，p53异常表达18例(4.9%)。370名患者中有13名（3.6%）观察到复发，两个是p53abn。当调整中位随访时间时，p53abn患者与p53野生型患者(p53wt)的复发比值比(OR)为5.23-95%CI0.98-27.95,p=0.053.最常见的复发部位是阴道袖带（46.2％）。在随访的第一年内发生了一次复发，患者表现为p53abn。p53abn和p53wt组的1年和2年DFS率分别为94.4%和100%,分别。一名患者死于该疾病并包含p53wt。两组之间的OS无差异；中位OS为21.9个月（16.4-30.1）。需要更大的多中心研究来调整p53abn低危EC患者的治疗。对所有EC患者进行分子分类可能具有成本效益，尽管我们的样本相对较小，p53abn患者似乎有更大的复发风险，特别是在当地和诊断两年后。
