1.Frequency and clinical features of deficient mismatch repair in ovarian clear cell and endometrioid carcinoma
Tamaki TANAKA ; Kazuhiro TAKEHARA ; Natsumi YAMASHITA ; Mika OKAZAWA-SAKAI ; Kazuya KURAOKA ; Norihiro TERAMOTO ; Kenichi TAGUCHI ; Katsushige YAMASHIRO ; Hidenori KATO ; Tomoya MIZUNOE ; Rie SUZUKI ; Dan YAMAMOTO ; Arisa UEKI ; Toshiaki SAITO
Journal of Gynecologic Oncology 2022;33(5):e67-
Objective:
To clarify the frequency of deficient mismatch repair (dMMR) in Japanese ovarian cancer patients, we examined microsatellite instability (MSI) status and immunohistochemistry (IHC) subtypes, including endometrioid carcinoma (EMC), clear cell carcinoma (CCC), or a mixture of both (Mix).
Methods:
We registered 390 patients who were diagnosed with EMC/CCC/Mix between 2006 and 2015 and treated at seven participating facilities. For 339 patients confirmed eligible by the Central Pathological Review Board, MSI, IHC, and MutL homolog 1 methylation analyses were conducted. The tissues of patients with Lynch syndrome (LS)-related cancer histories, such as colorectal and endometrial cancer, were also investigated.
Results:
MSI-high (MSI-H) status was observed in 2/217 CCC (0.9%), 10/115 EMC (8.7%), and 1/4 Mix (25%). Additionally, loss of MMR protein expression (LoE-MMR) was observed in 5/219 (2.3%), 16/115 (14.0%), and 1/4 (25%) patients with CCC, EMC, and Mix, respectively. Both MSI-H and LoE-MMR were found significantly more often in EMC (p<0.001). The median (range) ages of patients with MMR expression and LoE-MMR were 54 (30–90) and 46 (22–76) (p=0.002), respectively. In the multivariate analysis, advanced stage and histological type were identified as prognostic factors.
Conclusion
The dMMR rate for EMC/CCC was similar to that reported in Western countries. In Japan, it is assumed that the dMMR frequency is higher because of the increased proportion of CCC.
2.Clinicopathologic features, treatment, prognosis and prognostic factors of neuroendocrine carcinoma of the endometrium: a retrospective analysis of 42 cases from the Kansai Clinical Oncology Group/Intergroup study in Japan
Harunobu MATSUMOTO ; Mototsugu SHIMOKAWA ; Kaei NASU ; Ayumi SHIKAMA ; Takaya SHIOZAKI ; Masayuki FUTAGAMI ; Kentaro KAI ; Hiroaki NAGANO ; Taisuke MORI ; Mitsutake YANO ; Norihiro SUGINO ; Etsuko FUJIMOTO ; Norihito YOSHIOKA ; Satoshi NAKAGAWA ; Muneaki SHIMADA ; Hideki TOKUNAGA ; Yuki YAMADA ; Tomohiko TSURUTA ; Kazuto TASAKI ; Ryutaro NISHIKAWA ; Shiho KUJI ; Takashi MOTOHASHI ; Kimihiko ITO ; Takashi YAMADA ; Norihiro TERAMOTO
Journal of Gynecologic Oncology 2019;30(6):e103-
OBJECTIVE: We conducted a retrospective, multi-institutional, collaborative study to accumulate cases of neuroendocrine carcinoma of the endometrium, to clarify its clinicopathologic features, treatment, prognosis and prognostic factors to collate findings to establish future individualized treatment regimens. To our knowledge, this is the largest case study and the first study to statistically analyze the prognosis of this disease. METHODS: At medical institutions participating in the Kansai Clinical Oncology Group/Intergroup, cases diagnosed at a central pathologic review as neuroendocrine carcinoma of the endometrium between 1995 and 2014 were enrolled. We retrospectively analyzed the clinicopathologic features, treatment, prognosis and prognostic factors of this disease. RESULTS: A total of 65 cases were registered from 18 medical institutions in Japan. Of these, 42 (64.6%) cases were diagnosed as neuroendocrine carcinoma of the endometrium based on the central pathological review and thus included in the study. Advanced International Federation of Gynecology and Obstetrics stages (stage III and IV) and pure type small cell neuroendocrine carcinoma cases had a significantly worse prognosis. Upon multivariate analysis, only histologic subtypes and surgery were significant prognostic factors. Pure type cases had a significantly worse prognosis compared to mixed type cases and complete surgery cases had a significantly better prognosis compared to cases with no or incomplete surgery. CONCLUSION: Our findings suggest that complete surgery improves the prognosis of neuroendocrine carcinoma of the endometrium. Even among cases with advanced disease stages, if complete surgery is expected to be achieved, clinicians should consider curative surgery to improve the prognosis of neuroendocrine carcinoma of the endometrium.
Carcinoma, Large Cell
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Carcinoma, Neuroendocrine
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Carcinoma, Small Cell
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Endometrial Neoplasms
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Endometrium
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Female
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Gynecology
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Japan
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Medical Oncology
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Multivariate Analysis
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Obstetrics
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Prognosis
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Retrospective Studies