Retrospective Analysis of Molecular Markers in Endometrial Cancer: Single Center Experience

Abstract

Background : To emphasize the effect of molecular markers on prognosis in endometrial cancer, in addition to the International Federation of Gynecology and Obstetrics (FIGO) 2009 classification. Methods : The records of 160 patients with endometrial cancer between 2008 and 2022 were retrospectively reviewed. Staging was done according to FIGO 2009 criteria. Patients were divided into 4 groups according to molecular classification. If one had polymerase epsilon ( POLE ) mutation, the patient was included in POLE ultramutated (POLEmut) group. In case of intakt POLE , but abnormal staining of mismatch repair (MMR), the group was diagnosed as mismatch repair defciency (MMRd). If there was only p53 abnormal results detected, that group was p53-abnormal (p53mut). If no mutation at all, that group was categorized as non-specific molecular profile (NSMP). The Kaplan-Meier method was used to evaluate overall survival and progression-free survival. Survival rates were compared for molecular markers. Results : According to the molecular analysis, 4 patients (2.5%) were classifed as POLEmut group, 53 patients (33.1%) in the MMRd group, 18 patients (11.3%) had p53mut, and 85 patients (53.1%) into the NSMP group. 5-year overall survival was 79.4%, 5-year progression-free survival was 90%. 5-year overall survival was 75% in POLEmut group, 84.9% in MMRd group, 38.9% in p53mut group and 84.7% in NSMP group ( p = 0.001). 5-year progression-free survival was 100% in POLEmut group, 96.2% in MMRd group, 77.8% in p53mut group and 88.2% in NSMP group ( p = 0.082). Conclusion : Our study shows the prognostic value of the molecular endometrial cancer classification. Patients with p53mut have a poor progression-free survival, POLEmut endometrial cancer have a good prognosis. In this study, we wanted to demonstrate the importance of molecular markers in endometrium cancer and their contribution to prognosis.