• Eur. J. Cancer · Nov 2013

    Multicenter Study Clinical Trial

    Hormone receptor loss in endometrial carcinoma curettage predicts lymph node metastasis and poor outcome in prospective multicentre trial.

    • Jone Trovik, Elisabeth Wik, Henrica M J Werner, Camilla Krakstad, Harald Helland, Ingrid Vandenput, Tormund S Njolstad, Ingunn M Stefansson, Janusz Marcickiewicz, Solveig Tingulstad, Anne C Staff, MoMaTEC study group, Frederic Amant, Lars A Akslen, and Helga B Salvesen.
    • Department of Obstetrics and Gynecology, Haukeland University Hospital, Bergen, Norway; Department of Clinical Medicine, University of Bergen, Bergen, Norway. Electronic address: jone.trovik@helse-bergen.no.
    • Eur. J. Cancer. 2013 Nov 1;49(16):3431-41.

    BackgroundPreoperative histologic examination of tumour tissue is essential when deciding if endometrial cancer surgery should include lymph node sampling. We wanted to investigate if biomarkers could improve prediction of lymph node metastasis and outcome.Patients And MethodsCurettage specimens from 832 endometrial carcinoma patients prospectively recruited from 10 centres in the MoMaTEC trial (Molecular Markers in Treatment of Endometrial Cancer) were investigated for hormone receptor and p53 status.ResultsEighteen per cent of tumours were double negative for oestrogen- and progesterone receptors (ER/PR loss), 24% overexpressed p53. Pathologic expression of all markers correlated with nodal metastases, high FIGO (Federation International of Gynecology and Obstetrics) stage, non-endometrioid histology, high grade and poor prognosis (all P<0.001). ER/PR loss independently predicted lymph node metastasis (odds ratios (OR) 2.0, 95% confidence interval (CI) 1.1-3.7) adjusted for preoperative curettage histology and predicted poor disease-specific survival adjusted for age, FIGO stage, histologic type, grade and myometrial infiltration (hazard ratio (HR) 2.3, 95% CI 1.4-3.9). For lymph node negative endometrioid tumours, ER/PR loss influenced survival independent of grade.ConclusionDouble negative hormone receptor status in endometrial cancer curettage independently predicts lymph node metastasis and poor prognosis in a prospective multicentre setting. Implementing hormone receptor status to improve risk-stratification for selecting patients unlikely to benefit from lymphadenectomy seems justified.Copyright © 2013 The Authors. Published by Elsevier Ltd.. All rights reserved.

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