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Is p53 immunohistochemistry alone useful for delineating adjuvant endometrial treatment in low-middle-income countries?

  • 0Brazilian National Cancer Institute, Rio de Janeiro, Brazil; Oncologia D'OR, Rio de Janeiro, Brazil.
European Journal of Obstetrics, Gynecology, and Reproductive Biology +

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May 24, 2024

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May 24, 2024

View abstract on PubMed

Summary

This summary is machine-generated.

p53 immunohistochemistry can help identify high-risk endometrial cancer (EC) patients. Aberrant p53 expression is linked to worse outcomes, suggesting a benefit from more aggressive adjuvant treatment in low-middle income countries.

Area Of Science

  • Oncology
  • Molecular Pathology
  • Gynecologic Oncology

Background

  • Molecular classification has transformed endometrial cancer (EC) treatment.
  • Low-middle income countries (LMICs) face challenges integrating complex molecular diagnostics.
  • p53 immunohistochemistry offers a potential tool for risk stratification in EC.

Purpose Of The Study

  • To evaluate the utility of p53 immunohistochemistry in guiding adjuvant treatment decisions for FIGO stages I and II endometrial cancer.
  • To assess the prognostic value of p53 aberrant expression in EC patients.

Main Methods

  • Retrospective analysis of 265 EC patients treated between 2010-2016 with high-grade FIGO stage I/II histology.
  • p53 immunohistochemistry performed on tumor samples.
  • Survival outcomes (recurrence-free and overall survival) analyzed using Kaplan-Meier and Cox regression.

Main Results

  • Aberrant p53 expression (71.4%) was associated with older age, higher rates of relapse (29.6% vs 12.5%), and death (46.7% vs 22.2%).
  • No significant difference in relapse patterns was observed between p53 aberrant and wild-type groups.
  • Patients with aberrant p53 had significantly shorter median overall survival (92.2 months).
  • Chemotherapy reduced mortality in p53 aberrant tumors (p=0.014) but not in wild-type tumors (p=0.22).

Conclusions

  • Aberrant p53 expression portends worse outcomes in stage I/II EC.
  • Aggressive adjuvant treatment, including systemic therapy and radiotherapy, benefits patients with p53 aberrant tumors.
  • p53 immunohistochemistry can complement traditional pathology for treatment decisions in LMICs.

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