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| Content Provider | Springer Nature : BioMed Central |
|---|---|
| Author | Dankai, Wiyada Pongsuvareeyakul, Tip Phinyo, Phichayut Tejamai, Chontichaporn Teerapakpinyo, Chinachote Cheewakriangkrai, Chalong Lekawanvijit, Suree Siriaunkgul, Sumalee Khunamornpong, Surapan |
| Abstract | Background Endometrial carcinoma is molecularly categorized into four subgroups: polymerase-E exonuclease domain-mutant (POLE-mut), mismatch repair-deficient (MMR-d), p53-abnormal (p53-abn), and no specific molecular profile (NSMP). This classification scheme has been included into clinical recommendation for post-operative risk-based management, although there have been few Asian studies on this topic. The present study aimed to evaluate the prevalence and clinical outcomes of endometrial carcinoma using this classification in Northern Thailand and the feasibility of implementation in resource-limited settings. Methods Endometrial carcinomas from hysterectomy specimens were classified using immunohistochemistry for MMR proteins and p53, as well as POLE mutation testing. Clinicopathological variables and outcomes were analyzed. The costs of the molecular information-based approach were compared to those incurred by the conventional approach (without molecular classification). Results Of 138 patients, 52.9% in the NSMP subgroup, 28.2% were in the MMR-d, 13.8% in the p53-abn, and 5.1% in the POLE-mut. After adjusting for other variables, patients with POLE-mut showed the most favorable outcomes, while those with p53-abn had the poorest survival. When estimating the costs for post-operative management, the use of molecular classification resulted in a 10% increase over the conventional approach. However, the cost increased only by 1% if only POLE testing was used to identify patients for treatment omission. Conclusion In Northern Thailand, endometrial carcinoma had comparable subgroup distribution and prognostic implications to previous reports, supporting the implementation of management guidelines that incorporate molecular information. In resource-limited settings, at least POLE mutation testing in early-stage patients should be considered. |
| Related Links | https://bmcwomenshealth.biomedcentral.com/counter/pdf/10.1186/s12905-023-02677-6.pdf |
| Ending Page | 10 |
| Page Count | 10 |
| Starting Page | 1 |
| File Format | HTM / HTML |
| ISSN | 14726874 |
| DOI | 10.1186/s12905-023-02677-6 |
| Journal | BMC Women's Health |
| Issue Number | 1 |
| Volume Number | 23 |
| Language | English |
| Publisher | BioMed Central |
| Publisher Date | 2023-11-14 |
| Access Restriction | Open |
| Subject Keyword | Gynecology Maternal and Child Health Reproductive Medicine POLE mutation Endometrial carcinoma Molecular classification Resource-limited setting Management |
| Content Type | Text |
| Resource Type | Article |
| Subject | Obstetrics and Gynecology Reproductive Medicine |
| Journal Impact Factor | 2.4/2023 |
| 5-Year Journal Impact Factor | 2.9/2023 |
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