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Practical lessons learned from real-world implementation of the molecular classification for endometrial carcinoma

Title
Practical lessons learned from real-world implementation of the molecular classification for endometrial carcinoma
Type
Article in International Scientific Journal
Year
2023
Authors
Moreira, I
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Ferreira, M
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Garcia, S
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Novais, P
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Gama, J
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Ferro, B
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Leite Silva, P
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Frutuoso, C
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Pires, M
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Barbosa, A
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Pinto, C
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Pereira, D
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Bartosch, C
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Journal
Title: Gynecologic OncologyImported from Authenticus Search for Journal Publications
Vol. 176
Pages: 53-61
ISSN: 0090-8258
Publisher: Elsevier
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Publicação em ISI Web of Knowledge ISI Web of Knowledge - 0 Citations
Publicação em Scopus Scopus - 0 Citations
Other information
Authenticus ID: P-00Y-R44
Abstract (EN): Objectives. This study aimed to explore the practical organisational aspects and difficulties in the implemen-tation of the molecular classification of endometrial carcinoma (EC), and to demonstrate its potential impact in prognostic risk group classification. Methods. We conducted a multicentre, retrospective cohort study of 230 patients with EC diagnosed between 2019 and 2022. Sample processing, clinicopathological, treatment and follow-up data were collected. Molecular classification was obtained by p53 and mismatch repair proteins immunohistochemistry, and POLE next -generation sequencing.Results. Implementation was achieved through centralization of molecular analysis. In practice, it was possible to optimise turnaround times of complete integrative reports for hysterectomy specimens to a median time of 18 workdays. If genetic study was started in endometrial biopsies before surgery, 82.0% were available at the time of multidisciplinary tumour board, compared to 8.4% if performed in hysterectomy. ECs were classified as follows: 37.8% no specific molecular profile, 31.7% p53 abnormal, 24.3% mismatch repair deficient, and 6.1% POLE mutant. Integration of these results with traditional clinicopathologic factors led to a change in prognostic risk group in 15 (6.5%) patients, most being initially allocated to high-intermediate (n = 8) and low (n = 5) risk groups. Eight patients changed to a higher risk, and 7 to a lower risk group, whereas 2 remained in the same group. Conclusions. Centralization of EC molecular classification is a feasible option for countries with limited resources. Optimization of workflows may be achieved by earlier analysis in biopsies and prioritisation of patients whose results imply changes in risk group classification. & COPY; 2023 Published by Elsevier Inc.
Language: English
Type (Professor's evaluation): Scientific
No. of pages: 9
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