Prognostic Role of Hormone Status in Endometrium Cancer

Yıl 2022, Cilt: 13 Sayı: 3, 397 - 401, 27.09.2022

Seval Ay Özgecan Dülgar Hüseyin Kanmaz

https://doi.org/10.18663/tjcl.1143872

Öz

Aim: Endometrial carcinoma (EC) is the most common female reproductive system cancer in Europe and fifth leading reason of death in female cancer in worldwide. Hormone receptors are the main modulator of endometrium functions. Aim of present study was to evaluate prognostic indicator Estrogen receptors (ER) and progesterone receptor (PR) in patients at FIGO stage 3 EC.

Material and Methods: This study was designed as retrospective one institution analysis. ER status and PR status was enrolled from medical records of patients. Primary endpoint of this study was effect of hormone status to the disease-free survival (DFS) and overall survival (OS).

Results: Present study enrolled 133 patients from January 2015 to October 2021. ER and hormone positivity were statistically significant in OS analysis (HR: 1.40 p:0.005 and HR:2.173 p: 0.047). PR status was insignificant statistically in both DFS and OS survival analysis (HR: 1.80 p:0.09 and HR: 1.72, p: 0.062 respectively). The median DFS and OS were 58 months (51-64) and 129 months (88-169) patients with ER positive tumor respectively (p<0.0001), whereas 19 months (17-20) and 28 months (23-32) patients with ER negative tumor (p<0.000).

Conclusion: ER positivity was with better DFS and OS and was significantly good prognostic indicator in patients with FIGO stage 3. ER positivity may be used to stratify patients in FIGO stage 3 and close follow-up may be needed in patients in ER negative.

Anahtar Kelimeler

Endometrial carcinoma, estrogen receptors, progesterone receptors, FIGO stage 3, disease-free survival, overall survival

Teşekkür

I would like to thank to all co-authors those who studied present manuscript.

Endometrium kanserinde hormon reseptölerinin prognostik önemi

Öz

Amaç: Endometrium kanseri (EK) kadın üreme sisteminde Avrupa’da en sık beşinci sırada yer alan ve ölüme sebep olan kanserdir. Hormon reseptörleri (HR) endometrium fizyolojisinde ana modülatörlerindendir. Bu çalışmanın amacı Östrojen reseptörü (ÖR) ve progesterone reseptörünün (PR) opera olan FIGO ever 3 EK olgularında prognostik önemini belirlemektir.

Gereç ve Yöntemler: Bu çalışma tek merkezli retrospektif bir çalışma olarak tasarlandı. ÖR ve PR durumları hasta kayıtlarından incelendi. Çalışmanın birinci sonlanım noktası hormon reseptör durumlarının hastalıksız sağ kalım (HSK) ve genel sağ kalım (GSK) olan etkilerini incelemekti.

Bulgular: Mevcut çalışmada Ocak 2015 ile Ekim 2021 arasında 113 hasta tarandı. ÖR pozitifliği GSK analizi arasında istatistiki bir anlamlılık görüldü. (HR: 1.40 p:0.005 ve HR:2.173 p: 0.047). PR pozitiflik durumu hem HSK hem de GSK arasında istatistiki bir anlamlılığa ulaşamadı. (HR: 1.80 p:0.09 ve HR: 1.72, p: 0.062 sırasıyla). ÖÖR pozitif hastalarında ortanca HSK ve GSK sırasıyla 58 ay (51-64) ve 129 ay (88-169) olarak görülürken (p<0.0001), ÖR negatif hastalarda sırasıyla 19 ay (17-20) ve 28 ay (23-32) olarak gözlemlendi (p<0.000).

Sonuç: ÖR pozitif FIGO evre 3 hastaların hem HSK hem de GSK’ları daha iyi olması ÖR’ nün iyi bir prognostik gösterge olduğunu göstermektedir. FIGO evre 3'teki hastaları sınıflandırmak için ÖR pozitifliği kullanılabilir ve ÖR negatif olan hastalarda yakın takip gerekebilir.

Anahtar Kelimeler

Endometrium kanseri, östrojen reseptörü, progesteron reseptörü, FIGO evre 3, hastalıksız sağ kalım

Kaynakça

• 1. Ferlay J, Colombet M, Soerjomataram I, Parkin DM, Pineros M, Znaor A, et al. Cancer statistics for the year 2020: An overview. Int J Cancer. 2021.
• 2. Morice P, Leary A, Creutzberg C, Abu-Rustum N, Darai E. Endometrial cancer. Lancet. 2016;387(10023):1094-108.
• 3. Lewin SN, Herzog TJ, Barrena Medel NI, Deutsch I, Burke WM, Sun X, et al. Comparative performance of the 2009 international Federation of gynecology and obstetrics' staging system for uterine corpus cancer. Obstet Gynecol. 2010;116(5):1141-9.
• 4. Praiss AM, Huang Y, St Clair CM, Melamed A, Khoury-Collado F, Hou JY, et al. Long-term outcomes of vaginal hysterectomy for endometrial cancer. Gynecol Oncol. 2022;164(1):105-12.
• 5. Medina HN, Schlumbrecht MP, Penedo FJ, Pinheiro PS. Survival for endometrial cancer as a second primary malignancy. Cancer Med. 2022;11(6):1490-501.
• 6. Gompel A. Progesterone and endometrial cancer. Best Pract Res Clin Obstet Gynaecol. 2020;69:95-107.
• 7. Zhao D, Zhang F, Zhang W, He J, Zhao Y, Sun J. Prognostic role of hormone receptors in ovarian cancer: a systematic review and meta-analysis. Int J Gynecol Cancer. 2013;23(1):25-33.
• 8. Bonkhoff H. Estrogen receptor signaling in prostate cancer: Implications for carcinogenesis and tumor progression. Prostate. 2018;78(1):2-10.
• 9. Gompel A. [Hormone and breast cancer]. Presse Med. 2019;48(10):1085-91.
• 10. Thigpen T, Brady MF, Homesley HD, Soper JT, Bell J. Tamoxifen in the treatment of advanced or recurrent endometrial carcinoma: a Gynecologic Oncology Group study. J Clin Oncol. 2001;19(2):364-7.
• 11. Barker LC, Brand IR, Crawford SM. Sustained effect of the aromatase inhibitors anastrozole and letrozole on endometrial thickness in patients with endometrial hyperplasia and endometrial carcinoma. Curr Med Res Opin. 2009;25(5):1105-9. 12. Zou J, Fan YJ, Meng YQ, Xu H, Fan J. An exploratory analysis of gamma-synuclein expression in endometrioid endometrial cancer. BMJ Open. 2012;2(2):e000611.
• 13. Voss MA, Gordon N, Maloney S, Ganesan R, Ludeman L, McCarthy K, et al. Tetraspanin CD151 is a novel prognostic marker in poor outcome endometrial cancer. Br J Cancer. 2011;104(10):1611-8.
• 14. Liang J, Shang Y. Estrogen and cancer. Annu Rev Physiol. 2013;75:225-40.
• 15. Gehrig PA, Van Le L, Olatidoye B, Geradts J. Estrogen receptor status, determined by immunohistochemistry, as a predictor of the recurrence of stage I endometrial carcinoma. Cancer. 1999;86(10):2083-9.
• 16. Suthipintawong C, Wejaranayang C, Vipupinyo C. Prognostic significance of ER, PR, Ki67, c-erbB-2, and p53 in endometrial carcinoma. J Med Assoc Thai. 2008;91(12):1779-84.
• 17. Guan J, Xie L, Luo X, Yang B, Zhang H, Zhu Q, et al. The prognostic significance of estrogen and progesterone receptors in grade I and II endometrioid endometrial adenocarcinoma: hormone receptors in risk stratification. J Gynecol Oncol. 2019;30(1):e13.
• 18. Kleine W, Maier T, Geyer H, Pfleiderer A. Estrogen and progesterone receptors in endometrial cancer and their prognostic relevance. Gynecol Oncol. 1990;38(1):59-65.
• 19. Gonzalez-Rodilla I, Aller L, Llorca J, Munoz AB, Verna V, Estevez J, et al. The E-Cadherin expression vs. tumor cell proliferation paradox in endometrial cancer. Anticancer Res. 2013;33(11):5091-5.