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Prognostic value of molecular classification in stage IV endometrial cancer

  • 0Department of Gynecology, Rijnstate Hospital, Arnhem, The Netherlands.
International Journal of Gynecological Cancer : Official Journal of the International Gynecological Cancer Society +

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April 14, 2025

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April 14, 2025

View abstract on PubMed

Summary

This summary is machine-generated.

Molecular classification of stage IV endometrial cancer revealed a higher prevalence of poor prognostic subtypes. However, this classification did not significantly impact survival outcomes in advanced disease.

Area Of Science

  • Oncology
  • Molecular Pathology
  • Gynecologic Oncology

Background

  • Molecular classification is established as a prognostic tool for early-stage endometrial cancer.
  • Limited research exists on the prognostic value of molecular subtypes in stage IV endometrial cancer.
  • Advanced-stage endometrial cancer (stage IV) is associated with a poor prognosis.

Purpose Of The Study

  • To determine the distribution of molecular subclasses in stage IV endometrial cancer.
  • To assess the prognostic significance of molecular classification on progression-free and overall survival in stage IV endometrial cancer.
  • To investigate if molecular subtypes correlate with survival in advanced endometrial cancer.

Main Methods

  • Retrospective multicenter cohort study of 164 stage IV endometrial cancer patients.
  • Molecular classification performed centrally using WHO 2020 criteria (POLE, estrogen receptor status).
  • Kaplan-Meier analysis and log-rank tests used to evaluate survival in molecular subclasses.

Main Results

  • p53 abnormal (61.6%) and no specific molecular profile (21.3%) were the most common molecular subtypes in stage IV disease.
  • Molecular classification did not significantly impact progression-free survival (p=0.056) or overall survival (p=0.12).
  • Histologic subtype (p<0.0001) and estrogen receptor status (p=0.013) were significant prognostic factors for overall survival.

Conclusions

  • Stage IV endometrial cancer exhibits a different molecular subtype distribution compared to earlier stages, with more unfavorable subtypes.
  • Molecular classification lacks independent prognostic value in stage IV endometrial cancer.
  • Molecular subtypes may still inform adjuvant treatment decisions in advanced endometrial cancer.

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