文章：

评估2020年ESGO/ESTRO/ESP子宫内膜癌风险分子分类新系统对生存与复发预测的价值

Assessing the New 2020 ESGO/ESTRO/ESP Endometrial Cancer Risk Molecular Categorization System for Predicting Survival and Recurrence

原文发布日期：27 February 2024

DOI: 10.3390/cancers16050965

类型: Article

开放获取: 是

英文摘要：

This study aimed to evaluate the efficacy of the 2020 European Society of Gynecological Oncology/European Society for Radiotherapy and Oncology/European Society of Pathology (ESGO/ESTRO/ESP) guidelines for endometrial cancer (EC). Additionally, a novel risk category incorporating clinicopathological and molecular factors was introduced. The predictive value of this new category for recurrence and survival in Korean patients with EC was assessed, and comparisons were made with the 2013 and 2016 European Society of Medical Oncology (ESMO) risk classifications. Patients with EC were categorized into the POLE-mutated (POLEmut), mismatch repair-deficient (MMRd), p53-aberrant (P53abn), and nonspecific molecular profile (NSMP) subtypes. Recurrence, survival, and adjuvant therapy were assessed according to each classification. Notably, patients with the POLEmut subtype showed no relapse, while patients with the P53abn subtype exhibited higher recurrence (31.8%) and mortality rates (31.8%). Regarding adjuvant therapy, 33.3% of low-risk patients were overtreated according to the 2020 ESGO/ESTRO/ESP guidelines. Overall and progression-free survival differed significantly across molecular classifications, with the POLEmut subtype showing the best and the P53abn subtype showing the worst outcomes. The 2020 ESGO molecular classification system demonstrated practical utility and significantly influenced survival outcomes. Immunohistochemistry for TP53 and MMR, along with POLE sequencing, facilitated substantial patient reclassification, underscoring the clinical relevance of molecular risk categories in EC management.

摘要翻译： 

本研究旨在评估2020年欧洲妇科肿瘤学会/欧洲放射治疗与肿瘤学会/欧洲病理学会（ESGO/ESTRO/ESP）子宫内膜癌（EC）指南的临床应用价值。同时，我们提出了一种整合临床病理与分子特征的新型风险分层体系，并评估了该体系对韩国子宫内膜癌患者复发及生存的预测效能，同时与2013年及2016年欧洲肿瘤内科学会（ESMO）风险分层标准进行了比较。研究将子宫内膜癌患者分为POLE突变型（POLEmut）、错配修复缺陷型（MMRd）、p53异常型（P53abn）及非特异性分子谱型（NSMP）四种分子亚型，并根据不同分层标准评估了患者的复发、生存及辅助治疗情况。值得注意的是，POLEmut亚型患者未出现复发，而P53abn亚型患者复发率（31.8%）和死亡率（31.8%）均较高。在辅助治疗方面，依据2020年ESGO/ESTRO/ESP指南，33.3%的低危患者存在过度治疗现象。不同分子分型患者的总生存期和无进展生存期存在显著差异，其中POLEmut亚型预后最佳，P53abn亚型预后最差。2020年ESGO分子分型体系展现出显著的临床应用价值，并对患者生存结局产生重要影响。TP53与MMR的免疫组化检测及POLE基因测序实现了大量患者的风险再分层，凸显了分子风险分类在子宫内膜癌临床管理中的重要意义。

原文链接：

Assessing the New 2020 ESGO/ESTRO/ESP Endometrial Cancer Risk Molecular Categorization System for Predicting Survival and Recurrence