• endometrial cancer; prognostic factors

The aim of the study was to evaluate the prognostic value of a molecular-integrated risk profile classification in in patients with stage I-II endometrial cancer.
We retrospectively analysed 79 patients with endometrial cancer who underwent extrafascial hysterectomy with or without lymphadenectomy and adjuvant high-dose-rate (HDR) vaginal brachytherapy (VBT) in our Institution (Azienda Ospedaliera Universitaria Pisana, Division of Radiation Oncology). All women received VBT to the vaginal vault with a vaginal cylinder applicator and the VBT dose was 21 Gy in 3 fractions of 7 Gy, calculated at 5 mm from the applicator surface, with an overall treatment time of 2 weeks.
Based on histopathology reports, patients were assigned to the molecular-integrated unfavourable risk-profile group in case of substantial lymph-vascular space invasion (≥3 LVSI-involved vessels) or p53 overexpression.
In our analyses, any recurrence (including both local and distant disease relapses) occurred in the unfavourable molecular-integrated risk group: p53 overexpression and substantial LVSI were prognostic factors significantly associated with poor clinical outcomes and we found a statistically significant correlation between unfavourable molecular-integrated risk-profile and both pelvic and distant recurrence rate.
Our experience suggests that the new molecular-integrated classification could play an important role in determination of adjuvant treatment in patient affected by early-stage endometrial cancers.