Submit to Cancers Review for Cancers Propose a Special Issue

Journal Menu

Journal Browser

► Journal Browser

Endometrial Cancer: Old Questions and New Perspectives (Volume II)

Special Issue Editors
Special Issue Information
Keywords
Published Papers

A special issue of Cancers (ISSN 2072-6694). This special issue belongs to the section "Cancer Therapy".

Deadline for manuscript submissions: closed (30 April 2024) | Viewed by 8147

Share This Special Issue

Special Issue Editors

Dr. Anna Myriam Perrone

E-Mail Website
Guest Editor

Oncologic Gynecology Unit, Azienda Ospedaliero-Universitaria di Bologna, via Massarenti 9, 40138 Bologna, Italy
Interests: gynecologic oncology; minimally invasive surgery; molecular classification; fertility sparing treatment; medical treatment; radiotherapy; quality of life; palliative treatment; imaging
Special Issues, Collections and Topics in MDPI journals

Dr. Pierandrea De Iaco

E-Mail Website
Guest Editor

Oncologic Gynecology Unit, Azienda Ospedaliero-Universitaria di Bologna, via Massarenti 9, Bologna, Italy
Interests: gynecologic oncology; minimally invasive surgery; molecular classification; fertility sparing treatment; medical treatment; radiotherapy; quality of life; palliative treatment; imaging
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

This Special Issue is a continuation of our previous Special Issue, “Endometrial Cancer: Old Questions and New Perspectives” (https://www.mdpi.com/journal/cancers/special_issues/Endometrial_Cancer_Questions).

Endometrial cancers are a common neoplasia accounting for approximately 6% of all malignancies in women, and are a very heterogeneous group. Pre-operative diagnosis (ultrasound and RMI) is often very difficult due to the wide histopathological spectrum of lesions, and the correct therapeutic approach is very complex; for this reason, endometrial cancer should be addressed to reference centers. Hysterectomy represents the therapeutic mainstay for localized disease, but despite radical surgery, the risk of recurrence remains consistent, ranging between 15% and 20%. Laparoscopy is the preferred approach, but recent data on cervical cancer surgery (LAAC trial) require a thorough reassessment. The role of lymphadenectomy and of sentinel lymph node procedures is under evaluation. If diagnosis is performed in childbearing age, fertility preservation remains controversial, and chemotherapy and radiotherapy as adjuvant treatment are unresolved issues.

In this Special Issue, “Endometrial Cancer: Old Questions and New Perspectives (Volume II)”, experts in this field will discuss the current approaches to the management of patients with endometrial cancer: surgical treatment, the role of laparoscopic surgery, sentinel node procedure, and fertility-sparing surgery. They will also focus on the molecular and pathological aspects of this heterogeneous group of neoplasms, the role of medical treatments and radiotherapy, and the difficult role of imaging in the pre-operative setting.

Dr. Anna Myriam Perrone
Dr. Pierandrea De Iaco
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Cancers is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2900 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

endometrial cancer
minimally invasive surgery
sentinel node
fertility sparing
radiotherapy
medical treatment
imaging
molecular analysis
quality of life
palliative treatment

Published Papers (7 papers)

Download All Papers

Order results

Result details

Show export options Show export options

Select all

Export citation of selected articles as:

Research

Jump to: Review, Other

17 pages, 1236 KiB

Open AccessArticle

Implementation of HER2 Testing in Endometrial Cancer, a Summary of Real-World Initial Experience in a Large Tertiary Cancer Center

by Anna Plotkin, Ekaterina Olkhov-Mitsel, Weei-Yuarn Huang and Sharon Nofech-Mozes

Cancers 2024, 16(11), 2100; https://doi.org/10.3390/cancers16112100 - 31 May 2024

Viewed by 602

Abstract

HER2-targeted therapies have transformed the management of advanced or recurrent serous endometrial cancer (EC), leading to an increased clinical demand for HER2 testing. Despite its adoption in select academic centers, the global extent of such tumor testing is unclear. In this study, we report on the initial two-year experience of HER2 testing at a major academic center with a reference gynecologic oncology service and biomarker reference laboratory. All patients who underwent HER2 testing based on physician discretion, reflex HER2 testing, and reference laboratory requests were included. From February 2021 to October 2023, HER2 testing was performed on 192 tumor tissue samples from 180 EC patients. Serous carcinoma constituted 52% of samples, reflecting diagnostic challenges and limited therapeutic options for advanced EC. HER2 positivity was found in 28% of all cases and 30% of p53-aberrant cases. An immunohistochemistry (IHC) score of 3+ was found in 15% of samples, while IHC 2+ was found in 45% (13% IHC 2+/ISH+ and 32% IHC 2+/ISH−). The newly identified ‘HER2-low’ category comprised 46% of the samples. Heterogeneity was noted in 42% of HER2-positive cases, with complex patterns in 3%. NGS and HER2 IHC-FISH showed a 24% discordance, attributed to intratumoral heterogeneity, tumor cellularity, a small number of amplified cells, and the HER2/CEP17 ratio near the cut-off. This study offers real-world insights into HER2 testing in EC, highlighting the challenges and underscoring the need for standardized guidelines in specimen handling, proficiency testing, and scoring criteria to enhance patient management and therapeutic decision-making. Full article

(This article belongs to the Special Issue Endometrial Cancer: Old Questions and New Perspectives (Volume II))

► Show Figures

Figure 1

19 pages, 3330 KiB

Open AccessArticle

Hormone Receptor Expression and Activity for Different Tumour Locations in Patients with Advanced and Recurrent Endometrial Carcinoma

by Maartje M. W. Luijten, Willem Jan van Weelden, Roy I. Lalisang, Johan Bulten, Kristina Lindemann, Heleen J. van Beekhuizen, Hans Trum, Dorry Boll, Henrica M. J. Werner, Luc R. C. W. van Lonkhuijzen, Refika Yigit, Camilla Krakstad, Petronella O. Witteveen, Khadra Galaal, Alexandra A. van Ginkel, Eliana Bignotti, Vit Weinberger, Sanne Sweegers, Ane Gerda Z. Eriksson, Diederick M. Keizer, Anja van de Stolpe, Andrea Romano, Johanna M. A. Pijnenborg and European Network for Individualized Treatment in Endometrial Cancer Show full author list Hide full author list

Cancers 2024, 16(11), 2084; https://doi.org/10.3390/cancers16112084 - 30 May 2024

Viewed by 386

Abstract

Background: Response to hormonal therapy in advanced and recurrent endometrial cancer (EC) can be predicted by oestrogen and progesterone receptor immunohistochemical (ER/PR-IHC) expression, with response rates of 60% in PR-IHC > 50% cases. ER/PR-IHC can vary by tumour location and is frequently lost with tumour progression. Therefore, we explored the relationship between ER/PR-IHC expression and tumour location in EC. Methods: Pre-treatment tumour biopsies from 6 different sites of 80 cases treated with hormonal therapy were analysed for ER/PR-IHC expression and classified into categories 0–10%, 10–50%, and >50%. The ER pathway activity score (ERPAS) was determined based on mRNA levels of ER-related target genes, reflecting the actual activity of the ER receptor. Results: There was a trend towards lower PR-IHC (33% had PR > 50%) and ERPAS (27% had ERPAS > 15) in lymphogenic metastases compared to other locations (p = 0.074). Hematogenous and intra-abdominal metastases appeared to have high ER/PR-IHC and ERPAS (85% and 89% ER-IHC > 50%; 64% and 78% PR-IHC > 50%; 60% and 71% ERPAS > 15, not significant). Tumour grade and previous radiotherapy did not affect ER/PR-IHC or ERPAS. Conclusions: A trend towards lower PR-IHC and ERPAS was observed in lymphogenic sites. Verification in larger cohorts is needed to confirm these findings, which may have implications for the use of hormonal therapy in the future. Full article

(This article belongs to the Special Issue Endometrial Cancer: Old Questions and New Perspectives (Volume II))

► Show Figures

Graphical abstract

13 pages, 2431 KiB

Open AccessArticle

Assessing the New 2020 ESGO/ESTRO/ESP Endometrial Cancer Risk Molecular Categorization System for Predicting Survival and Recurrence

by Yung-Taek Ouh, Yoonji Oh, Jinwon Joo, Joo Hyun Woo, Hye Jin Han, Hyun Woong Cho, Jae Kwan Lee, Yikyeong Chun, Myoung-nam Lim and Jin Hwa Hong

Cancers 2024, 16(5), 965; https://doi.org/10.3390/cancers16050965 - 27 Feb 2024

Viewed by 1210

Abstract

This study aimed to evaluate the efficacy of the 2020 European Society of Gynecological Oncology/European Society for Radiotherapy and Oncology/European Society of Pathology (ESGO/ESTRO/ESP) guidelines for endometrial cancer (EC). Additionally, a novel risk category incorporating clinicopathological and molecular factors was introduced. The predictive value of this new category for recurrence and survival in Korean patients with EC was assessed, and comparisons were made with the 2013 and 2016 European Society of Medical Oncology (ESMO) risk classifications. Patients with EC were categorized into the POLE-mutated (POLEmut), mismatch repair-deficient (MMRd), p53-aberrant (P53abn), and nonspecific molecular profile (NSMP) subtypes. Recurrence, survival, and adjuvant therapy were assessed according to each classification. Notably, patients with the POLEmut subtype showed no relapse, while patients with the P53abn subtype exhibited higher recurrence (31.8%) and mortality rates (31.8%). Regarding adjuvant therapy, 33.3% of low-risk patients were overtreated according to the 2020 ESGO/ESTRO/ESP guidelines. Overall and progression-free survival differed significantly across molecular classifications, with the POLEmut subtype showing the best and the P53abn subtype showing the worst outcomes. The 2020 ESGO molecular classification system demonstrated practical utility and significantly influenced survival outcomes. Immunohistochemistry for TP53 and MMR, along with POLE sequencing, facilitated substantial patient reclassification, underscoring the clinical relevance of molecular risk categories in EC management. Full article

(This article belongs to the Special Issue Endometrial Cancer: Old Questions and New Perspectives (Volume II))

► Show Figures

Graphical abstract

15 pages, 1584 KiB

Open AccessArticle

A Radiomic-Based Machine Learning Model Predicts Endometrial Cancer Recurrence Using Preoperative CT Radiomic Features: A Pilot Study

by Camelia Alexandra Coada, Miriam Santoro, Vladislav Zybin, Marco Di Stanislao, Giulia Paolani, Cecilia Modolon, Stella Di Costanzo, Lucia Genovesi, Marco Tesei, Antonio De Leo, Gloria Ravegnini, Dario De Biase, Alessio Giuseppe Morganti, Luigi Lovato, Pierandrea De Iaco, Lidia Strigari and Anna Myriam Perrone

Cancers 2023, 15(18), 4534; https://doi.org/10.3390/cancers15184534 - 13 Sep 2023

Cited by 1 | Viewed by 1234

Abstract

Background: Current prognostic models lack the use of pre-operative CT images to predict recurrence in endometrial cancer (EC) patients. Our study aimed to investigate the potential of radiomic features extracted from pre-surgical CT scans to accurately predict disease-free survival (DFS) among EC patients. Methods: Contrast-Enhanced CT (CE-CT) scans from 81 EC cases were used to extract the radiomic features from semi-automatically contoured volumes of interest. We employed a 10-fold cross-validation approach with a 6:4 training to test set and utilized data augmentation and balancing techniques. Univariate analysis was applied for feature reduction leading to the development of three distinct machine learning (ML) models for the prediction of DFS: LASSO-Cox, CoxBoost and Random Forest (RFsrc). Results: In the training set, the ML models demonstrated AUCs ranging from 0.92 to 0.93, sensitivities from 0.96 to 1.00 and specificities from 0.77 to 0.89. In the test set, AUCs ranged from 0.86 to 0.90, sensitivities from 0.89 to 1.00 and specificities from 0.73 to 0.90. Patients classified as having a high recurrence risk prediction by ML models exhibited significantly worse DSF (p-value < 0.001) across all models. Conclusions: Our findings demonstrate the potential of radiomics in predicting EC recurrence. While further validation studies are needed, our results underscore the promising role of radiomics in forecasting EC outcomes. Full article

(This article belongs to the Special Issue Endometrial Cancer: Old Questions and New Perspectives (Volume II))

► Show Figures

Figure 1

Review

Jump to: Research, Other

21 pages, 341 KiB

Open AccessReview

The Promotive and Inhibitory Role of Long Non-Coding RNAs in Endometrial Cancer Course—A Review

by Patryk Jasielski, Izabela Zawlik, Anna Bogaczyk, Natalia Potocka, Sylwia Paszek, Michał Maźniak, Aleksandra Witkoś, Adrianna Korzystka, Aleksandra Kmieć and Tomasz Kluz

Cancers 2024, 16(11), 2125; https://doi.org/10.3390/cancers16112125 - 3 Jun 2024

Viewed by 631

Abstract

Endometrial cancer is one of the most common malignant tumours in women. The development of this tumour is associated with several genetic disorders, many of which are still unknown. One type of RNA molecules currently being intensively studied in many types of cancer are long non-coding RNAs (lncRNAs). LncRNA-coding genes occupy a large fraction of the human genome. LncRNAs regulate many aspects of cell development, metabolism, and other physiological processes. Diverse types of lncRNA can function as a tumour suppressor or an oncogene that can alter migration, invasion, cell proliferation, apoptosis, and immune system response. Recent studies suggest that selected lncRNAs are important in an endometrial cancer course. Our article describes over 70 lncRNAs involved in the development of endometrial cancer, which were studied via in vivo and in vitro research. It was proved that lncRNAs could both promote and inhibit the development of endometrial cancer. In the future, lncRNAs may become an important therapeutic target. The aim of this study is to review the role of lncRNAs in the development of carcinoma of uterine body. Full article

(This article belongs to the Special Issue Endometrial Cancer: Old Questions and New Perspectives (Volume II))

13 pages, 645 KiB

Open AccessReview

Old Issues and New Perspectives on Endometrial Cancer Therapy: How Molecular Characteristics Are Changing the Therapeutic Pathway

by Daniela Luvero, Gianna Barbara Cundari, Fernando Ficarola, Francesco Plotti, Corrado Terranova, Roberto Montera, Giorgio Bogani, Adele Silvagni, Federica Celoro and Roberto Angioli

Cancers 2024, 16(10), 1866; https://doi.org/10.3390/cancers16101866 - 14 May 2024

Viewed by 917

Abstract

The Cancer Genome Atlas (TCGA) has radically changed the history of endometrial cancer by outlining a new classification, based on its molecular characteristics. In the field of oncology, we are approaching the new era of molecular biology, particularly regarding endometrial cancer, with the increasing importance of targeted therapy. This paper is a review of phase III randomized controlled trials published in English between January 2019 and December 2023, comparing drugs of interest with standard adjuvant treatment and molecular subtypes in endometrial cancer. The use of immunotherapy alone or in combination with chemotherapy as therapy in patients with recurrent or advanced primary or metastatic endometrial cancer significantly improves the prognosis of these patients. The results show greater efficacy of all proposed treatments for mismatch repair deficiency (dMMR/MSI-H) patients compared to mismatch repair proficiency (pMMR) patients. Progression-free survival (PFS) and overall survival (OS) are better in dMMR patients in all studies analysed. Immunotherapy has the potential to revolutionize the gynaecological cancer treatment landscape, offering a new pathway and new hope for endometrial cancer patients, improving their outcomes in the future. Given the exciting results obtained in dMMR/MSI-H patients, MMR status should be investigated in every patient with advanced endometrial cancer at the time of diagnosis. Full article

(This article belongs to the Special Issue Endometrial Cancer: Old Questions and New Perspectives (Volume II))

► Show Figures

Figure 1

Other

Jump to: Research, Review

18 pages, 2609 KiB

Open AccessSystematic Review

Efficacy and Safety of PD-1/PD-L1 Inhibitor as Single-Agent Immunotherapy in Endometrial Cancer: A Systematic Review and Meta-Analysis

by Mohd Nazzary Mamat @ Yusof, Kah Teik Chew, Abdul Muzhill Hannaan Abdul Hafizz, Siti Hajar Abd Azman, Wira Sofran Ab Razak, Muhammad Rafi’uddin Hamizan, Nirmala Chandralega Kampan and Mohamad Nasir Shafiee

Cancers 2023, 15(16), 4032; https://doi.org/10.3390/cancers15164032 - 9 Aug 2023

Cited by 6 | Viewed by 2499

Abstract

The programmed cell death protein 1 (PD-1)/programmed cell death ligand 1 (PD-L1) pathway plays a crucial role in the immune escape mechanism and growth of cancer cells in endometrial cancer (EC). Clinical trials investigating PD-1/PD-L1 inhibitor have shown promising results in other cancers, but their efficacy in EC still remains uncertain. Therefore, this meta-analysis aims to provide an updated and robust analysis of the effectiveness and safety of PD-1/PDL1 inhibitor as single-agent immunotherapy in EC, focusing on the objective response rate (ORR), disease control rate (DCR), and adverse events (AEs). This meta-analysis utilized STATA version 17 and RevMan version 5.4 software to pool the results of relevant studies. Five studies conducted between 2017 and 2022, comprising a total of 480 EC patients enrolled for PD-1/PD-L1 inhibitor immunotherapy met the inclusion criteria. The pooled proportion of EC patients who achieved ORR through PD-1/PD-L1 inhibitor treatment was 26.0% (95% CI: 16.0–36.0%; p < 0.05). Subgroup analysis based on mismatch repair (MMR) status showed an ORR of 44.0% (95% CI: 38.0–50.0%; p = 0.32) for the deficient mismatch repair (dMMR) group and 8.0% (95% CI: 0.0–16.0%; p = 0.07) for the proficient mismatch repair (pMMR) group. Pooled proportion analysis by DCR demonstrated an odds ratio (OR) of 41.0% (95% CI: 36.0–46.0%, p = 0.83) for patients undergoing PD-1/PD-L1 inhibitor treatment. Subgroup analysis based on MMR status revealed DCR of 54.0% (95% CI: 47.0–62.0%; p = 0.83) for the dMMR group, and 31.0% (95% CI: 25.0–39.0%; p = 0.14) for the pMMR group. The efficacy of PD-1/PD-L1 inhibitors was significantly higher in the dMMR group compared to the pMMR group, in terms of both ORR (OR = 6.30; 95% CI = 3.60–11.03; p < 0.05) and DCR (OR = 2.57; 95% CI = 1.66–3.99; p < 0.05). In terms of safety issues, the pooled proportion of patients experiencing at least one adverse event was 69.0% (95% CI: 65.0–73.0%; p > 0.05), with grade three or higher AEs occurring in 16.0% of cases (95% CI: 12.0–19.0%; p > 0.05). Based on the subgroup analysis of MMR status, PD-1/PD-L1 inhibitor immunotherapy showed significantly better efficacy among dMMR patients. These findings suggest that patients with dMMR status may be more suitable for this treatment approach. However, further research on PD-1/PD-L1 inhibitor immunotherapy strategies is needed to fully explore their potential and improve treatment outcomes in EC. Full article

(This article belongs to the Special Issue Endometrial Cancer: Old Questions and New Perspectives (Volume II))

► Show Figures

Journal Menu

Journal Browser

Endometrial Cancer: Old Questions and New Perspectives (Volume II)

Share This Special Issue

Special Issue Editors

Special Issue Information

Keywords

Published Papers (7 papers)

Research

Review

Other

Further Information

Guidelines

MDPI Initiatives

Follow MDPI