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.
目前尚无前瞻性研究验证分子分型在指导子宫内膜癌（EC）辅助治疗中的应用，对于形态学低危EC患者甚至缺乏回顾性数据。为此，我们开展了一项回顾性、多中心、观察性研究，纳入370例低危子宫内膜样EC患者，旨在评估p53异常表达（p53abn）在这一特定亚组中的发生率及其预后意义。在370例患者中，18例（4.9%）存在p53异常表达。370例患者中有13例（3.6%）出现复发，其中2例为p53abn。经中位随访时间校正后，p53abn组相较于p53野生型（p53wt）组的复发比值比（OR）为5.23（95% CI 0.98–27.95，p=0.053）。最常见的复发部位为阴道残端（46.2%）。1例复发发生在随访第一年内，该患者表现为p53abn。p53abn组与p53wt组的1年及2年无病生存率分别为94.4%和100%。1例患者死于本病，该患者为p53wt。两组间总生存期无显著差异，中位总生存期为21.9个月（16.4–30.1）。未来需要更大规模的多中心研究来优化p53abn低危EC患者的治疗方案。对所有EC患者进行分子分型可能具有成本效益，尽管本研究样本量有限，但p53abn患者似乎具有更高的复发风险，尤其是局部复发及诊断两年后的复发。
肿瘤(癌症)患者之家