Impact of lower uterine segment involvement in type II endometrial cancer and the unique mutational profile of serous tumors

Liron Kogan, David Octeau, Zainab Amajoud, Jeremie Abitbol, Ido Laskov, Alex Ferenczy, Manuela Pelmus, Neta Eisenberg, Roy Kessous, Susie Lau, Amber Yasmeen, Walter H. Gotlieb, Shannon Salvador

Research output: Contribution to journalArticlepeer-review

3 Scopus citations

Abstract

Objective: Evaluation of the impact of lower uterine segment involvement (LUSI) in type II endometrial cancer, and mutational profile of uterine papillary serous carcinomas (UPSC). Methods: Retrospective cohort study comparing patients with type II endometrial cancer with LUSI to patients without LUSI. Genes commonly implicated in carcinogenesis were analyzed in a subgroup of 42 patients with UPSC using next generation sequencing. Results: 83 patients with type II endometrial cancer were included in the study, of these, LUSI was diagnosed in 31.3%. During a median follow-up of 45.5 months, patients with LUSI developed more local and distant recurrences (local: 19.2% vs. 3.5%, P =.03; distant: 50% vs. 17.5%, P =.004) and progression events (73.1% vs. 26.3%, P <.001), with shorter mean progression-free survival (16 months compared to 26.5 months, P <.01). In a multivariate analysis, LUSI was the only significant pathological factor, associated with a 2.9-fold increase in the risk of progression (P =.007), and a 2.6-fold increase in the risk of death (P =.02). In the subgroup of patients with UPSC, mutations were identified in 54 genes, including TP53 (80%), PPP2R1A (40%), and PTEN (22.5%). Frequent mutations in the PTEN-PI3K-AKT signaling pathway were found in patients with tumor in the upper uterine segment only (P =.04), with PTEN being mutated in 29% of the samples (P =.07). Conclusion: Type II endometrial cancers presenting in the LUS have a significantly worse prognosis and this might be associated with a unique mutational profile.

Original languageEnglish
Pages (from-to)43-47
Number of pages5
JournalGynecologic Oncology Reports
Volume24
DOIs
StatePublished - 1 May 2018
Externally publishedYes

Keywords

  • Gene analysis
  • Lower uterine segment
  • PTEN mutation
  • Sequencing
  • Type II endometrial cancer
  • Uterine papillary serous carcinoma

ASJC Scopus subject areas

  • Oncology
  • Obstetrics and Gynecology

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