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Updated: Jan 29, 2026
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Sentinel Lymph Node Mapping and Biopsy for Endometrial Cancer at Early Stage with Laparoscopy
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Molecular Classification and Clinical Outcomes in Endometrial Cancer: Real-World Evidence from a Tertiary Care Center
Tanadon Salakphet1, Prapaporn Suprasert1, Tip Pongsuvareeyakul2
1Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand.
Cancers
|January 28, 2026
Summary
Molecular classification of endometrial carcinoma (EC) effectively predicts patient outcomes. Immunohistochemistry for mismatch repair (MMR) and p53 are valuable initial tests, guiding risk stratification for personalized EC treatment.
Area of Science:
- Gynecologic Oncology
- Molecular Pathology
- Cancer Genomics
Background:
- Endometrial carcinoma (EC) classification is crucial for prognosis and treatment.
- Limited real-world data exists for Asian populations regarding EC molecular subtypes.
- This study investigates EC molecular subtypes in a Thai tertiary care setting.
Purpose of the Study:
- To evaluate clinicopathologic features of EC molecular subtypes in a Thai population.
- To assess survival outcomes across different molecular subtypes of EC.
- To determine the utility of molecular classification for risk stratification in EC.
Main Methods:
- Retrospective cohort study of 184 EC patients undergoing primary surgery (2015-2023).
- Molecular classification included immunohistochemistry (IHC) for mismatch repair (MMR) proteins and p53, plus POLE sequencing.
- Statistical analyses involved Chi-square, logistic regression, Kaplan-Meier, and log-rank tests.
Main Results:
- Subtypes identified: POLE-mutated (2.2%), MMR-deficient (dMMR) (38.6%), p53-abnormal (p53-abn) (45.1%), and NSMP (1.6%).
- Histologic type independently predicted MMR deficiency and p53 abnormality.
- Survival outcomes varied significantly: POLE-mutated (excellent), dMMR (intermediate), and p53-abn (poorest PFS and OS).
Conclusions:
- Molecular classification offers robust prognostic discrimination in EC.
- MMR and p53 IHC are practical frontline tools for EC risk assessment.
- Prioritizing POLE sequencing for specific EC subtypes and expanding testing in Asian populations can refine management.
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