Objective:To assess the correlation between ProMisE classification and lymph node metastasis(LNM) of endometrial carcinoma(EC). Design:A retrospective cohort study. Setting:Department of gynecologic oncology at Liaoning Cancer Hospital in China. Population:From January 1st,2014 to December 31st, 2018,a total of 74 women with EC were included.32 cases had pelvic or para-aortic LNM and 42 cases had no LNM. Methods:The formalin-fixed paraffin-embedded(FFPE) tissue sections of EC patients were analyzed by the Proactive Molecular Risk Classifier for Endometrial cancer (ProMisE) classification,and to evaluate the correlation between ProMisE classification and LNM and prognosis of the patients receiving different postoperative adjuvant therapies. Main outcome measure:Correlation between ProMisE classification and LNM,Overall Survival(OS) and progression-free survival(PFS). Results: In the ProMisE classification,mismatch repair deficient(MMRd) was linked to low pathological grade (p value=0.006; correlation=-0.315), p53 abnormal subtype(p53abn) was correlated with LNM (p value=0.0004; correlation=-0.472) and late International Federation of Gynecology and Obstetrics (FIGO) stage (p value=0.005; correlation=-0.386).The 5-year overall survival was 100% in Polymerase Epsilon exonuclease domain mutated(POLE EDM), 85% in MMRd, 91.2% in p53 wild-type(p53wt) and 83.3% in p53abn.The 5-year PFS was 100% in POLE EDM, 95% in MMRd, 94.1% in p53wt and 77.8% in p53abn.We also found no statistical difference in patients‘ benefits from Radiotherapy(RT) alone and concurrent chemoradiotherapy(CCRT) in different molecular subtypes,however,the patients had a trend toward benefit from CCRT in the p53abn subtype. Conclusions:ProMisE classification can predict the risk of LNM,histological grade,clinical staging and prognosis, which is expected to guide the postoperative adjuvant treatment of EC patients.

Objective: This study aimed to determine the high risk factors of ovarian metastasis of EC, to enable accurate evaluation of whether young EC patients can retain ovaries.Design:A large sample retrospective case-control study.Setting and population:All EC patients were treated and registered in the Liaoning Cancer Hospital between January 2006 and December 2017;aged 25-80 years.Methods: The study cohort was divided into two groups: EC patients with ovarian metastasis and without ovarian metastasis.To analyze ovarian metastasis on prognosis after propensity score matching (PSM) based on the stratified analysis of independent risk factors for ovarian metastasis.Main outcome measure:overall survival (OS) and progress free survival(PFS).Results: A total of 1240 patients diagnosed with EC were eligible for analysis, of which 120 (9.7%) had ovarian metastasis. The EC patients with ovarian metastasis were more likely to have deep myometrial infiltration, lymph node metastasis and elevated CA125.Median follow-up time was 52 months (13-131 months); the median survival was 39 months in patients with ovarian metastasis and 111 months in those without ovarian metastasis (p＜0.001).Compared with EC patients without ovarian metastasis, the risk for death increased by 14.37 times in those with ovarian metastasis.According to the stratified analysis,PFS and OS of EC patients with ovarian metastasis in the low-risk group,and PFS of patients in the high-risk group were significantly shorter than those without ovarian metastasis (p＜0.0001,p=0.0034;p＜0.0001).Conclusion: Deep myometrial invasion, lymph node metastasis and elevated CA125 were independent risk factors for ovarian metastasis of EC patients. Ovarian metastasis is an independent predictor of poor survival among EC patients.