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Kato MK, Fujii E, Asami Y, Momozawa Y, Hiranuma K, Komatsu M, Hamamoto R, Ebata T, Matsumoto K, Ishikawa M, Kohno T, Kato T, Yoshida H, Shiraishi K. Clinical features and impact of p53 status on sporadic mismatch repair deficiency and Lynch syndrome in uterine cancer. Cancer Sci 2024; 115:1646-1655. [PMID: 38433331 PMCID: PMC11093186 DOI: 10.1111/cas.16121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Revised: 01/10/2024] [Accepted: 02/08/2024] [Indexed: 03/05/2024] Open
Abstract
The clinical features of sporadic mismatch repair deficiency (MMRd) and Lynch syndrome (LS) in Japanese patients with endometrial cancer (EC) were examined by evaluating the prevalence and prognostic factors of LS and sporadic MMRd in patients with EC. Targeted sequencing of five LS susceptibility genes (MLH1, MSH2, MSH6, PMS2, and EPCAM) was carried out in 443 patients with EC who were pathologically diagnosed with EC at the National Cancer Center Hospital between 2011 and 2018. Pathogenic variants in these genes were detected in 16 patients (3.7%). Immunohistochemistry for MMR proteins was undertaken in 337 of the 433 (77.9%) EC patients, and 91 patients (27.0%) showed absent expression of at least one MMR protein. The 13 cases of LS with MMR protein loss (93.8%) showed a favorable prognosis with a 5-year overall survival (OS) rate of 100%, although there was no statistically significant difference between this group and the sporadic MMRd group (p = 0.27). In the MMRd without LS group, the 5-year OS rate was significantly worse in seven patients with an aberrant p53 expression pattern than in those with p53 WT (53.6% vs. 93.9%, log-rank test; p = 0.0016). These results suggest that p53 abnormalities and pathogenic germline variants in MMR genes could be potential biomarkers for the molecular classification of EC with MMRd.
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Affiliation(s)
- Mayumi Kobayashi Kato
- Division of Genome BiologyNational Cancer Center Research InstituteTokyoJapan
- Department of GynecologyNational Cancer Center HospitalTokyoJapan
| | - Erisa Fujii
- Division of Genome BiologyNational Cancer Center Research InstituteTokyoJapan
- Department of GynecologyNational Cancer Center HospitalTokyoJapan
| | - Yuka Asami
- Division of Genome BiologyNational Cancer Center Research InstituteTokyoJapan
- Department of Obstetrics and GynecologyShowa University School of MedicineTokyoJapan
| | - Yukihide Momozawa
- Laboratory for Genotyping Development, RIKEN Center for Integrative Medical SciencesYokohamaJapan
| | - Kengo Hiranuma
- Division of Genome BiologyNational Cancer Center Research InstituteTokyoJapan
| | - Masaaki Komatsu
- Division of Medical AI Research and DevelopmentNational Cancer Center Research InstituteTokyoJapan
- Cancer Translational Research Team, RIKEN Center for Advanced Intelligence ProjectTokyoJapan
| | - Ryuji Hamamoto
- Division of Medical AI Research and DevelopmentNational Cancer Center Research InstituteTokyoJapan
- Cancer Translational Research Team, RIKEN Center for Advanced Intelligence ProjectTokyoJapan
| | - Takahiro Ebata
- Department of Epigenomics, Life Science Tokyo Advanced Research CenterHoshi UniversityTokyoJapan
| | - Koji Matsumoto
- Department of Obstetrics and GynecologyShowa University School of MedicineTokyoJapan
| | - Mitsuya Ishikawa
- Department of GynecologyNational Cancer Center HospitalTokyoJapan
| | - Takashi Kohno
- Division of Genome BiologyNational Cancer Center Research InstituteTokyoJapan
| | - Tomoyasu Kato
- Department of GynecologyNational Cancer Center HospitalTokyoJapan
| | - Hiroshi Yoshida
- Department of Diagnostic PathologyNational Cancer Center HospitalTokyoJapan
| | - Kouya Shiraishi
- Division of Genome BiologyNational Cancer Center Research InstituteTokyoJapan
- Department of Clinical GenomicsNational Cancer Center Research InstituteTokyoJapan
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Zouridis A, Zarrindej K, Rencher J, Pappa C, Kashif A, Smyth SL, Sadeghi N, Sattar A, Damato S, Ferrari F, Laganà AS, Abdalla M, Kehoe S, Addley S, Soleymani Majd H. The Prognostic Characteristics and Recurrence Patterns of High Grade Endometrioid Endometrial Cancer: A Large Retrospective Analysis of a Tertiary Center. J Clin Med 2023; 12:jcm12093141. [PMID: 37176582 PMCID: PMC10179027 DOI: 10.3390/jcm12093141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Revised: 04/09/2023] [Accepted: 04/17/2023] [Indexed: 05/15/2023] Open
Abstract
High grade endometrioid endometrial cancer (HGEEC) is a heterogeneous group of tumors with unclear prognostic features. The aim of the present study is to evaluate the independent risk factors for recurrence and mortality and to describe the recurrence patterns of HGEEC. Ninety-six consecutive cases of HGEEC treated with primary surgery in a single Tertiary Center were retrospectively reviewed. Clinicopathological and treatment details were recorded, and all patients were closely followed up. Disease-free, overall and cancer-specific survival rates were 83.8%, 77.8% and 83.6%, respectively. Cervical stromal involvement was independently related to recurrence (HR = 25.67; 95%CI 2.95-223.30; p = 0.003) and cancer-related death (HR = 15.39; 95%CI 1.29-183.43; p = 0.031) after adjusting for other pathological and treatment variables. Recurrence rate was 16%, with 60% of these cases having lung metastases and only one case with single vaginal vault recurrence. 81.81% of the recurrences presented with symptoms and not a single recurrence was diagnosed in routine follow-up clinical examination. In conclusion, the recurrence pattern may suggest that patient-initiated follow-up (PIFU) could be considered a potential alternative to clinical-based follow-up for HGEEC survivors, especially for patients without cervical involvement and after two years from treatment. Additional caution is needed in patients with cervical stromal involvement.
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Affiliation(s)
- Andreas Zouridis
- Oxford University Hospitals NHS Foundation Trust, Oxford OX3 7LE, UK
| | | | - Joshua Rencher
- Royal Berkshire NHS Foundation Trust, Reading RG1 5AN, UK
| | - Christina Pappa
- Oxford University Hospitals NHS Foundation Trust, Oxford OX3 7LE, UK
| | - Ammara Kashif
- Oxford University Hospitals NHS Foundation Trust, Oxford OX3 7LE, UK
| | | | - Negin Sadeghi
- Oxford University Hospitals NHS Foundation Trust, Oxford OX3 7LE, UK
| | - Alisha Sattar
- Oxford University Hospitals NHS Foundation Trust, Oxford OX3 7LE, UK
| | - Stephen Damato
- Oxford University Hospitals NHS Foundation Trust, Oxford OX3 7LE, UK
| | - Federico Ferrari
- Department of Clinical and Experimental Sciences, University of Brescia, 25136 Brescia, Italy
| | - Antonio Simone Laganà
- Unit of Gynecologic Oncology, ARNAS "Civico-Di Cristina-Benfratelli", Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, 90127 Palermo, Italy
| | - Mostafa Abdalla
- Gynaecology-Guy's and St Thomas' NHS Foundation Trust, London SE1 9RT, UK
| | - Sean Kehoe
- Oxford University Hospitals NHS Foundation Trust, Oxford OX3 7LE, UK
| | - Susan Addley
- University Hospitals of Derby and Burton NHS Foundation Trust, Derby DE22 3NE, UK
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Kobayashi Kato M, Asami Y, Takayanagi D, Matsuda M, Shimada Y, Hiranuma K, Kuno I, Komatsu M, Hamamoto R, Matumoto K, Ishikawa M, Kohno T, Kato T, Shiraishi K, Yoshida H. Clinical impact of genetic alterations of
CTNNB1
in patients with grade 3 endometrial endometrioid carcinoma. Cancer Sci 2022; 113:1712-1721. [PMID: 35278272 PMCID: PMC9128156 DOI: 10.1111/cas.15328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 02/17/2022] [Accepted: 03/07/2022] [Indexed: 11/30/2022] Open
Abstract
To identify prognostic factors in patients with grade 3 (high‐grade) endometrial endometrioid carcinoma, we evaluated the spectrum of genomic alterations and examined whether previously reported molecular subtypes of endometrial carcinoma were adapted to clinical outcome prediction. Seventy‐five Japanese patients with grade 3 endometrial endometrioid carcinoma, who underwent a potentially curative resection procedure between 1997 and 2018 at the National Cancer Center Hospital, were included. We classified the patients into four risk groups of the disease based on the Proactive Molecular Risk Classifier for Endometrial Cancer. Genomic alterations in PTEN, ARID1A, TP53, and PIK3CA were detected in more than 30% of the patients. Overall survival and recurrence‐free survival of patients with genomic alterations in CTNNB1 were poorer than those of patients with wild‐type CTNNB1 (p = 0.006 and p = 0.004, respectively). Compared with that of alterations prevalent in Caucasians, the frequency of genomic alterations in POLE and TP53 was higher in our study than in The Cancer Genome Atlas dataset (p = 0.01 and p = 0.01, respectively). The tendency for recurrence‐free survival in the POLE exonuclease domain mutation group was better than that in the TP53 mutation and mismatch repair‐deficient groups (p = 0.08 and p = 0.07, respectively), consistent with the Proactive Molecular Risk Classifier for Endometrial Cancer risk classifier definition. The CTNNB1 mutation is a potential novel biomarker for the prognosis of patients with grade 3 endometrial endometrioid carcinoma, and prognosis classification using Proactive Molecular Risk Classifier for Endometrial Cancer may help screen Japanese patients with the disease.
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Affiliation(s)
- Mayumi Kobayashi Kato
- Division of Genome Biology National Cancer Center Research Institute Tokyo 104‐0045 Japan
- Department of Gynecology National Cancer Center Hospital Tokyo 104‐0045 Japan
| | - Yuka Asami
- Division of Genome Biology National Cancer Center Research Institute Tokyo 104‐0045 Japan
- Department of Obstetrics and Gynecology Showa University School of Medicine Tokyo 142‐8555 Japan
| | - Daisuke Takayanagi
- Division of Genome Biology National Cancer Center Research Institute Tokyo 104‐0045 Japan
| | - Maiko Matsuda
- Division of Genome Biology National Cancer Center Research Institute Tokyo 104‐0045 Japan
| | - Yoko Shimada
- Division of Genome Biology National Cancer Center Research Institute Tokyo 104‐0045 Japan
| | - Kengo Hiranuma
- Division of Genome Biology National Cancer Center Research Institute Tokyo 104‐0045 Japan
| | - Ikumi Kuno
- Department of Gynecology National Cancer Center Hospital Tokyo 104‐0045 Japan
| | - Masaaki Komatsu
- Division of Medical AI Research and Development National Cancer Center Research Institute Tokyo 104‐0045 Japan
- Cancer Translational Research Team RIKEN Center for Advanced Intelligence Project Tokyo 103‐0027 Japan
| | - Ryuji Hamamoto
- Division of Medical AI Research and Development National Cancer Center Research Institute Tokyo 104‐0045 Japan
- Cancer Translational Research Team RIKEN Center for Advanced Intelligence Project Tokyo 103‐0027 Japan
| | - Koji Matumoto
- Department of Obstetrics and Gynecology Showa University School of Medicine Tokyo 142‐8555 Japan
| | - Mitsuya Ishikawa
- Department of Gynecology National Cancer Center Hospital Tokyo 104‐0045 Japan
| | - Takashi Kohno
- Division of Genome Biology National Cancer Center Research Institute Tokyo 104‐0045 Japan
| | - Tomoyasu Kato
- Department of Gynecology National Cancer Center Hospital Tokyo 104‐0045 Japan
| | - Kouya Shiraishi
- Division of Genome Biology National Cancer Center Research Institute Tokyo 104‐0045 Japan
| | - Hiroshi Yoshida
- Division of Diagnostic Pathology National Cancer Center Hospital Tokyo 104‐0045 Japan
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