Association of Local and Distant Organ Metastases With MELF Pattern in Endometrial Cancer

Area of Science:

• Gynecologic Oncology
• Pathology
• Cancer Research

Background:

• Endometrioid-type endometrial adenocarcinoma (EEC) exhibits various myometrial invasion patterns.
• The microcystic elongated and fragmented (MELF) pattern is one such pattern requiring further investigation regarding its prognostic significance.

Purpose of the Study:

• To investigate the association between the MELF pattern and recurrence type in EEC patients.
• To determine the impact of the MELF pattern on disease-free survival and overall survival rates in EEC.

Main Methods:

• Retrospective review of 108 EEC patients diagnosed between January 2011 and January 2021.
• Comparison of MELF pattern prevalence between patients with and without recurrence, and stratified by recurrence type (local vs. distant).
• Analysis of 5-year disease-free survival and overall survival rates in relation to MELF pattern positivity.

Main Results:

• The MELF pattern was significantly more frequent in patients with recurrence (40.7%) compared to those without (14.8%) (P=0.002).
• MELF positivity was strongly associated with local recurrence (60.0%) compared to distant metastases (29.4%) (P=0.027).
• MELF positivity was an independent negative predictor for local recurrence (OR=19.4) and was linked to decreased 5-year disease-free survival (P=0.003) and overall survival (P=0.001).

Conclusions:

• The MELF pattern is more prevalent in recurrent EEC, especially local recurrence, suggesting a role in direct local invasion.
• MELF positivity is a significant independent predictor of local recurrence and is associated with poorer survival outcomes in EEC patients.