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Comparable Survival of Grade 3 Endometrioid and Serous Endometrial Carcinoma, with TP53 Mutations

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Abstract

The distinction between endometrioid endometrial carcinoma (EEC) and serous endometrial carcinoma (SEC) is critical for treatment, but this proves difficult in poorly differentiated tumors. Molecular classification systems have been studied to streamline this task. TP53 mutations are associated with poor prognosis and aggressive behavior and are informally named “serous-like.” This study aims to compare the 2-year survival of high-grade EEC patients with TP53 mutations to those with SEC and to evaluate the prognostic implications of TP53 abnormalities. A retrospective cohort study was conducted on 62 patients with grade 3 EEC (n = 29) or SEC (n = 33) at Quaem Hospital, Mashhad, Iran, from March 2018 to December 2022. TP53 and mismatch repair status were determined using surrogate immunohistochemistry. Demographic data, clinical characteristics, and survival outcomes were analyzed. Kaplan–Meier survival curves and Cox proportional hazards regression models were used to assess 2-year overall survival (OS) and recurrence-free survival (RFS). Baseline characteristics were comparable, except for endometrial thickness, which was higher in EEC patients (p = 0.002). No significant differences were observed in 2-year OS (EEC3: 69% vs. SEC: 58%, p = 0.49) or local failure rates (EEC3: 31% vs. SEC: 29%, p = 0.870) between the two groups. Multivariate analysis identified CA-125 levels as a significant predictor of OS (HR = 1.00, 95% CI 1.001–1.005, p = 0.008). High-grade EEC with TP53 mutations exhibits a similarly unfavorable prognosis to SEC, which can be used to inform more intensive treatment strategies. Routine p53 immunohistochemistry testing is recommended to improve risk stratification and guide personalized treatment strategies, particularly in diagnostically challenging cases.

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Data Availability

All data for this scientific article are available in excel format and can be procured upon contacting the corresponding author.

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References

  1. Adjuvant treatment in early stage endometrial cancer: context-dependent impact of somatic CTNNB1 mutation on recurrence-free survival – PMC [WWW Document], n.d. https://doi.org/10.1136/ijgc-2021-003340.

  2. Ayeni TA, Bakkum-Gamez JN, Mariani A, McGree ME, Weaver AL, Haddock MG, Keeney GL, Long HJ, Dowdy SC, Podratz KC. Comparative outcomes assessment of uterine grade 3 endometrioid, serous, and clear cell carcinomas. Gynecol Oncol. 2013;129:478–85. https://doi.org/10.1016/j.ygyno.2013.03.011.

    Article PubMed Google Scholar

  3. Bokhman JV. Two pathogenetic types of endometrial carcinoma. Gynecol Oncol. 1983;15:10–7. https://doi.org/10.1016/0090-8258(83)90111-7.

    Article CAS PubMed Google Scholar

  4. Cancer Genome Atlas Research Network, Kandoth C, Schultz N, Cherniack AD, Akbani R, Liu Y, Shen H, Robertson AG, Pashtan I, Shen R, Benz CC, Yau C, Laird PW, Ding L, Zhang W, Mills GB, Kucherlapati R, Mardis ER, Levine DA. Integrated genomic characterization of endometrial carcinoma. Nature. 2013;497:67–73. https://doi.org/10.1038/nature12113.

    Article CAS Google Scholar

  5. Classification systems of endometrial cancer: a comparative study about old and new [WWW Document], n.d. https://doi.org/10.3390/diagnostics12010033.

  6. Clinicopathological and molecular characterisation of ‘multiple‐classifier’ endometrial carcinomas – PMC [WWW Document], n.d. https://doi.org/10.1002/path.5373.

  7. Diabetes mellitus is a multivariate independent prognostic factor in endometrial carcinoma: a clinicopathologic study on 313 patients [WWW Document], n.d. https://doi.org/10.12892/ejgo20070295.

  8. Hamilton CA, Cheung MK, Osann K, Chen L, Teng NN, Longacre TA, Powell MA, Hendrickson MR, Kapp DS, Chan JK. Uterine papillary serous and clear cell carcinomas predict for poorer survival compared to grade 3 endometrioid corpus cancers. Br J Cancer. 2006;94:642–6. https://doi.org/10.1038/sj.bjc.6603012.

    Article CAS PubMed PubMed Central Google Scholar

  9. International Journal of Gynecological Pathology [WWW Document], n.d. https://doi.org/10.1097/PGP.0b013e3181cd6552.

  10. International Journal of Gynecological Pathology [WWW Document], n.d. https://doi.org/10.1097/PGP.0000000000000674.

  11. Köbel M, Piskorz AM, Lee S, Lui S, LePage C, Marass F, Rosenfeld N, Mes Masson A-M, Brenton JD. Optimized p53 immunohistochemistry is an accurate predictor of TP53 mutation in ovarian carcinoma. The Journal of Pathology: Clinical Research. 2016;2:247–58. https://doi.org/10.1002/cjp2.53.

    Article CAS PubMed PubMed Central Google Scholar

  12. Modarres-Gilani M, Vaezi M, Shariat M, Zamani N, Nourizadeh R. The prognostic role of preoperative serum CA125 levels in patients with advanced endometrial carcinoma. Cancer Biomark. 2017;20:135–41. https://doi.org/10.3233/CBM-160529.

    Article CAS PubMed Google Scholar

  13. Oaknin A, Bosse TJ, Creutzberg CL, Giornelli G, Harter P, Joly F, Lorusso D, Marth C, Makker V, Mirza MR, Ledermann JA, Colombo N. Endometrial cancer: ESMO Clinical Practice Guideline for diagnosis, treatment and follow-up☆. Ann Oncol. 2022;33:860–77. https://doi.org/10.1016/j.annonc.2022.05.009.

    Article CAS PubMed Google Scholar

  14. Reproducibility of histological cell type in high-grade endometrial carcinoma – PubMed [WWW Document], n.d. https://doi.org/10.1038/modpathol.2013.102.

  15. Role of immunohistochemistry to distinguish grade 3 endometrioid carcinoma and uterine serous carcinoma – PubMed [WWW Document], n.d. https://doi.org/10.1097/PAI.0000000000000720.

  16. The American Journal of Surgical Pathology [WWW Document], n.d. https://doi.org/10.1097/PAS.0b013e31825dd4b3.

  17. The American Journal of Surgical Pathology [WWW Document], n.d. https://doi.org/10.1097/PAS.0b013e31827f576a.

  18. The rise of a novel classification system for endometrial carcinoma; integration of molecular subclasses – McAlpine – 2018 – The Journal of Pathology – Wiley Online Library [WWW Document], n.d. https://doi.org/10.1002/path.5034.

  19. The value of preoperative CA 125 levels in prediction of myometrial invasion in patients with early-stage endometrioid- type endometrial cancer – PubMed [WWW Document], n.d. https://pubmed.ncbi.nlm.nih.gov/26925634/.

  20. Type I and II endometrial cancers: have they different risk factors? – PubMed [WWW Document], n.d. https://doi.org/10.1200/JCO.2012.48.2596.

  21. Uterine serous and grade 3 endometrioid carcinomas – Boruta – 2004 – Cancer – Wiley Online Library [WWW Document], n.d. https://doi.org/10.1002/cncr.20645.

  22. Vaziri Fard E, Imboden S, Rau T, Epstein E, Petta TB, Walia S, Carlson JW. p53 abnormal (copy number high) endometrioid endometrial carcinoma has a prognosis indistinguishable from serous carcinoma. Int J Gynecol Pathol. 2024;43:515–26. https://doi.org/10.1097/PGP.0000000000001012.

    Article CAS PubMed Google Scholar

  23. Yilmaz, E., Gurocak, S., Melekoglu, R., Koleli, I., Faydali, S., Temelli, O., Yar, T., 2019. The effect of prognostic factors and adjuvant radiotherapy on survival in patients with high-grade early-stage endometrial cancer: a retrospective clinical study. Med Sci Monit 25, 2811–2818. https://doi.org/10.12659/MSM.913740.

Acknowledgements

Authors would like to thank Mashhad University of Medical Sciences for providing equipment to conduct this work.

Funding

This study was conducted under the supervision of Mashhad University of Medical Sciences, and the equipment for our study was provided by them. Other than the equipment, this research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Author information

Authors and Affiliations

  1. Gynecologic Oncology Fellowship, Obstetrics and Gynecology Department, Faculty of Medicine, Zahedan University of Medical Sciences, Zahedan, Iran

    Maryam Esmaeilpour

  2. Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran

    Mohammad Mahdi Kakoienejad & Babak Goodarzy

  3. Department of Gynecology Oncology, Faculty of Mashhad, Mashhad University of Medical Sciences, Mashhad, Iran

    Malihe Hasanzadeh & Marjaneh Farazestanian

  4. Molecular Pathology and Cytogenetic Fellowship, Department of Pathology, Mashhad University of Medical Sciences, Mashhad, Iran

    Anita Alenabi

Contributions

M.H. and M.F. developed and supervised the project M.E. collected data A.A. collected data and provided pathology expertise M.K. analyzed the data and wrote the manuscript B.G. also wrote the manuscript All authors reviewed the manuscript.

Corresponding author

Correspondence to Anita Alenabi.

Ethics declarations

Ethics Approval and Consent to Participate

This study was performed in line with the principles of the Declaration of Helsinki. Approval was obtained from the Research Ethics Committee of Mashhad University of Medical Sciences, Iran (MUMS) (IR.MUMS.MEDICAL.REC.1400.829).

Consent to Participate

Due to the retrospective nature of the study, we relied on written consent obtained at the time of admission for data usage, and the ethics committee waived the requirement for reconfirming consent.

Consent for Publication

All authors consent for this article and its data to be shared publicly.

Competing interests

Some authors are employed in Mashhad University of Medical Sciences, but declare no competing interests otherwise.

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Cite this article

Esmaeilpour, M., Kakoienejad, M.M., Hasanzadeh, M. et al. Comparable Survival of Grade 3 Endometrioid and Serous Endometrial Carcinoma, with TP53 Mutations. SN Compr. Clin. Med. 7, 210 (2025). https://doi.org/10.1007/s42399-025-01903-6

  • Received
  • Revised
  • Accepted
  • Published
  • DOI https://doi.org/10.1007/s42399-025-01903-6

Keywords

  • Endometrial neoplasm
  • TP53 mutation
  • Serous endometrial carcinoma
  • Endometrioid carcinoma

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