%N 20
%T Endometrial Cancer Molecular Risk Stratification is Equally Prognostic for Endometrioid Ovarian Carcinoma
%V 26
%A P Krämer
%A A Talhouk
%A MA Brett
%A DS Chiu
%A ES Cairns
%A DA Scheunhage
%A RF Hammond
%A D Farnell
%A TM Nazeran
%A M Grube
%A Z Xia
%A J Senz
%A S Leung
%A L Feil
%A J Pasternak
%A K Dixon
%A A Hartkopf
%A B Krämer
%A S Brucker
%A F Heitz
%A A du Bois
%A P Harter
%A F Kommoss
%A H-P Sinn
%A S Heublein
%A F Kommoss
%A H-W Vollert
%A R Manchanda
%A CD de Kroon
%A HW Nijman
%A M de Bruyn
%A EF Thompson
%A A Bashashati
%A JN McAlpine
%A N Singh
%A AV Tinker
%A A Staebler
%A T Bosse
%A S Kommoss
%A M Köbel
%A MS Anglesio
%D 2020
%P 5400-5410
%J Clinical Cancer Research
%L discovery10106983
%O This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
%C United States
%X Purpose: Endometrioid ovarian carcinoma (ENOC) is generally associated with a more favorable prognosis compared to other ovarian carcinomas. Nonetheless, current patient treatment continues to follow a "one-size-fits-all" approach. Even though tumor staging offers stratification, personalized treatments remain elusive. As ENOC shares many clinical and molecular features with its endometrial counterpart, we sought to investigate TCGA-inspired endometrial cancer (EC) molecular subtyping in a cohort of ENOC. Experimental Design: Immunohistochemistry and mutation biomarkers were used to segregate 511 ENOC tumors into four EC-inspired molecular subtypes: low-risk POLE mutant (POLEmut); moderate-risk mismatch repair deficient (MMRd); high-risk p53 abnormal (p53abn); moderate-risk with no specific molecular profile (NSMP). Survival analysis with established clinicopathological and subtypes specific features was performed. Results: 3.5% of cases were POLEmut, 13.7% MMRd, 9.6% p53abn and 73.2% NSMP, each showing distinct outcomes (p <0.001) and survival similar to observations in EC. Median OS was 18.1 years in NSMP, 12.3 years in MMRd; 4.7 years in p53abn and not reached for POLEmut cases. Subtypes were independent of stage, grade, and residual disease in multivariable analysis. Conclusions: EC-inspired molecular classification provides independent prognostic information in ENOC. Our findings support investigating molecular-subtype specific management recommendations for ENOC patients; for example, subtypes may provide guidance when fertility-sparing treatment is desired. Similarities between ENOC and EC suggest that ENOC patients may benefit from management strategies applied to EC and the opportunity to study those in umbrella trials.