Journal article
Prognostic Effect of Mismatch Repair Status in Early-Stage Endometrial Cancer Treated With Adjuvant Radiation: A Multi-institutional Analysis
International journal of radiation oncology, biology, physics, v 119(4), pp 1158-1165
15 Jul 2024
PMID: 38253292
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
The aim of this work was to report the effect of mismatch repair (MMR) status on outcomes of patients with stage I-II endometrioid endometrial adenocarcinoma (EEC) who receive adjuvant radiation therapy.
This is a multi-institutional retrospective cohort study across 11 institutions in North America. Patients with known MMR status and stage I-II EEC status postsurgical staging were included. Overall survival (OS) and recurrence-free survival (RFS) rates were estimated via the Kaplan-Meier method. Univariable and multivariable analyses were performed via Cox proportional hazard models for RFS and OS. Statistical analyses were conducted using SPSS version 27.
In total, 744 patients with a median age at diagnosis of 65 years (IQR, 58-71) were included. Most patients were White (69.4%) and had Federation of Obstetrics and Gynecology 2009 stage I (84%) and Federation of Obstetrics and Gynecology grade 1 to 2 (73%). MMR deficiency was reported in 234 patients (31.5%), whereas 510 patients (68.5%) had preserved MMR. External beam radiation therapy with or without vaginal brachytherapy was delivered to 186 patients (25%), whereas 558 patients (75%) received vaginal brachytherapy alone. At a median follow-up of 43.5 months, the estimated crude OS and RFS rates for the entire cohort were 92.5% and 84%, respectively. MMR status was significantly correlated with RFS. RFS was inferior for MMR deficiency compared with preserved MMR (74.3% vs 88.6%, P < .001). However, no difference in OS was seen (90.8% vs 93.2%, P = .5). On multivariable analysis, MMR deficiency status was associated with worse RFS (hazard ratio, 1.86; P = .001) but not OS.
MMR status was independently associated with RFS but not OS in patients with early-stage EEC who were treated with adjuvant radiation therapy. These findings suggest that differential approaches to surveillance and/or treatment based on MMR status could be warranted.
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Details
- Title
- Prognostic Effect of Mismatch Repair Status in Early-Stage Endometrial Cancer Treated With Adjuvant Radiation: A Multi-institutional Analysis
- Creators
- Lara Hathout - Rutgers, The State University of New JerseyZohaib K Sherwani - Rutgers, The State University of New JerseyJosephine Alegun - Rutgers, The State University of New JerseyNisha Ohri - Rutgers, The State University of New JerseyEmma C Fields - Virginia Commonwealth UniversityShubhangi Shah - Virginia Commonwealth UniversitySushil Beriwal - Allegheny Health NetworkZachary D Horne - Allegheny Health NetworkElizabeth A Kidd - Stanford UniversityEric W Leung - Sunnybrook Health Science CentreJiheon Song - Sunnybrook Health Science CentreNeil K Taunk - University of PennsylvaniaJunzo Chino - Duke Medical CenterChristina Huang - Duke Medical CenterAndrea L Russo - Massachusetts General HospitalMichael Dyer - Harvard UniversityJessie Li - Yale UniversityKevin V Albuquerque - The University of Texas Southwestern Medical CenterShari Damast - Yale University
- Publication Details
- International journal of radiation oncology, biology, physics, v 119(4), pp 1158-1165
- Publisher
- Elsevier
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Radiation Oncology (and Nuclear Medicine)
- Web of Science ID
- WOS:001255326400001
- Scopus ID
- 2-s2.0-85185574150
- Other Identifier
- 991021897275004721
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- Collaboration types
- Domestic collaboration
- International collaboration
- Web of Science research areas
- Oncology
- Radiology, Nuclear Medicine & Medical Imaging