L1CAM as a prognostic marker in stage I endometrial cancer: a validation study

Area of Science:

• Oncology
• Molecular Biology
• Cancer Biomarkers

Background:

• L1 cell adhesion molecule (L1CAM) overexpression is associated with poor prognosis in early-stage endometrial cancer (EC).
• Validation of L1CAM as a prognostic marker in an independent cohort is crucial for clinical application.

Purpose of the Study:

• To validate the prognostic significance of L1CAM expression in early-stage endometrioid endometrial carcinoma.
• To assess the association between L1CAM positivity and risks of relapse and death.

Main Methods:

• Retrospective analysis of 450 patients with FIGO stage I endometrioid EC.
• L1CAM expression assessed by immunohistochemistry (>10% staining defined as positive).
• Risk of relapse and death estimated using hazard ratios in univariate and multivariate analyses.

Main Results:

• L1CAM positivity was observed in 9% of evaluable patients (35/388).
• L1CAM was not significantly associated with relapse or all-cause death in multivariate analysis.
• L1CAM positivity showed a significant association with increased relapse risk in patients not treated with chemotherapy (HR 2.9; P=0.04).

Conclusions:

• L1CAM is associated with a more aggressive tumor type and distant relapses.
• The overall recurrence rate was low, limiting the power to detect significant differences.
• L1CAM did not prove to be a clinically relevant marker of poor prognosis in this independent cohort of stage I endometrioid EC.