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

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

Deadline for manuscript submissions: 30 April 2024 | Viewed by 4345

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 (3 papers)

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13 pages, 2431 KiB  
Article
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 781
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 [...] Read more.
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))
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15 pages, 1584 KiB  
Article
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
Viewed by 1019
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. [...] Read more.
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))
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Other

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18 pages, 2609 KiB  
Systematic 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 - 09 Aug 2023
Cited by 4 | Viewed by 2059
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, [...] Read more.
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))
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