Retrospective Analysis Suggests Molecular Profiling Often Not Beneficial in Low-Grade Endometrial Cancer

In JAMA Network Open, researchers from Radboud University Medical Center and elsewhere share results suggesting routine molecular profiling beyond Lynch syndrome screening  may not improve outcomes for individuals with low-grade endometrial cancer — a condition that appeared to have favorable prognoses across its known molecular subtypes. Using next-generation sequence- and immunohistochemistry-based profiles, the team retrospectively classified almost 400 endometrial cases diagnosed in Europe from the mid-1990s through 2018 into four molecular subgroups: POLE-altered, microsatellite instable, TP53-altered, or no specific molecular profile. While five-year survival tended to be lower in patients with high-grade, TP53-altered, stage III or IV endometrial cancer, the authors found, low-grade endometrial cancer cases had favorable five-year survival patterns across the molecular subtypes considered. "The findings of this cohort study suggest that routine molecular profiling would not be beneficial in patients with low-grade [endometrial cancer] due to their excellent prognosis independent of molecular subgroup," they write. "Our data demonstrate the importance of primary diagnostic tumor grading and do not support routine molecular profiling in low-grade [endometrial cancer] as a cost-effective approach."