Evidence map›Paper›PMID 36241860›Full record

ArticleModern pathology : an official journal of the United States and Canadian Academy of Pathology, Inc2022

Variability in endometrial carcinoma pathology practice: opportunities for improvement with molecular classification.

Emily F Thompson, Jutta Huvila, Amy Jamieson, Samuel Leung, Amy Lum, Saul Offman, Alice Lytwyn, Mona Lisa Sur, Lynn Hoang, Julie Irving and 34 more

Abstract read
PubMed Publisher
In one paragraph

Article in Modern pathology : an official journal of the United States and Canadian Academy of Pathology, Inc, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
15citing papers in PubMed, 1 pooled it
7.8field-weighted citation impact, top 2% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

15 citing papers in PubMed, 1 synthesis or guideline pooled it, 46 citations in OpenAlex.

  1. Pooled it
  2. Quantitative analysis of trends and inequalities in disease burden and care quality of gynecological cancers, 1990-2021.European journal of cancer prevention : the official journal of the European Cancer Prevention Organisation (ECP) · 2026
    Article
  3. Article
  4. Article
  5. Review
  6. Article
  7. Article
  8. Article
  9. Article
  10. Article
  11. Targeted and Shallow Whole-Genome Sequencing Identifies Therapeutic Opportunities in p53abn Endometrial Cancers.Clinical cancer research : an official journal of the American Association for Cancer Research · 2024
    Article
  12. Article
  13. Clinical Behavior and Molecular Landscape of Stage I p53-Abnormal Low-Grade Endometrioid Endometrial Carcinomas.Clinical cancer research : an official journal of the American Association for Cancer Research · 2023
    Article
  14. Article
  15. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

44 authors at 19 institutions in 3 countries.

Emily F ThompsonDepartment of Molecular Oncology, University of British Columbia, Vancouver, BC, Canada.ORCID 0000-0002-1486-3304
Jutta HuvilaDepartment of Molecular Oncology, University of British Columbia, Vancouver, BC, Canada.
Amy JamiesonDepartment of Gynaecology and Obstetrics and Division of Gynaecologic Oncology, University of British Columbia, Vancouver, BC, Canada.
Samuel LeungGenetic Pathology Evaluation Centre, University of British Columbia, Vancouver, BC, Canada.
Amy LumDepartment of Molecular Oncology, University of British Columbia, Vancouver, BC, Canada.
Saul OffmanDepartment of Pathology and Laboratory Medicine, Dalhousie University, Halifax, NS, Canada.
Alice LytwynDepartment of Pathology and Molecular Medicine, McMaster University and The Juravinski Hospital and Cancer Centre, Hamilton, ON, Canada.
Mona Lisa SurDepartment of Pathology and Molecular Medicine, McMaster University and The Juravinski Hospital and Cancer Centre, Hamilton, ON, Canada.
Lynn HoangDepartment of Pathology and Laboratory Medicine, University of British Columbia and Vancouver General Hospital, Vancouver, BC, Canada.
Julie IrvingDepartment of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada.
Nicholas van der WesthuizenDepartment of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada.
Chantale MorinPathology Department, Centre Hospitalier Universitaire de Québec at Laval University and L'Hôtel-Dieu de Québec, Quebec, QC, Canada.
Cyrille BicamumpakaDepartment of Pathology, University of Manitoba, Winnipeg, MB, Canada.
Nazilla AzordeganDepartment of Pathology, University of Manitoba, Winnipeg, MB, Canada.
François GougeonDepartment of Molecular Biology, Medical Biochemistry and Pathology, Centre Hospitalier Universitaire de Montréal at Université de Montréal, Montreal, QC, Canada.
Kaoutar Ennour-IdrissiDepartment of Molecular Biology, Medical Biochemistry and Pathology, Centre Hospitalier Universitaire de Québec at Université de Laval, Quebec, QC, Canada.
Janine SenzDepartment of Molecular Oncology, University of British Columbia, Vancouver, BC, Canada.
Melissa K McConechyCanexia Health, Vancouver, BC, Canada.
Rosalia Aguirre-HernandezCanexia Health, Vancouver, BC, Canada.
Victoria LuiFaculty of Science, University of British Columbia, Vancouver, BC, Canada.
Carolyn KuoObstetrics, Gynecology and Reproductive Sciences Residency Program, University of Manitoba, Winnipeg, MB, Canada.
Cassidy BellMD Undergraduate Program, University of Saskatchewan, Saskatoon, SK, Canada.
Taylor SalisburyDepartment of Pathology and Laboratory Medicine, University of British Columbia and Vancouver General Hospital, Vancouver, BC, Canada.
James LawsonMD undergraduate program, University of British Columbia, Vancouver, BC, Canada.
Ellen HeMD undergraduate program, University of British Columbia, Vancouver, BC, Canada.
Shanzhao WangDepartment of Molecular Oncology, University of British Columbia, Vancouver, BC, Canada.
Derek ChiuDepartment of Molecular Oncology, University of British Columbia, Vancouver, BC, Canada.
Sarah KeanDivision of Gynecologic Oncology, University of Manitoba, Winnipeg, MB, Canada.
Vanessa SamouëlianDepartment of Obstetrics and Gynecology, Centre Hospitalier de l'Université de Montréal, Montreal, QC, Canada.
Shannon SalvadorDivision of Gynecologic Oncology, Lady Davis Institute of Research, Jewish General Hospital, McGill University, Montreal, QC, Canada.
Walter GotliebDivision of Gynecologic Oncology, Lady Davis Institute of Research, Jewish General Hospital, McGill University, Montreal, QC, Canada.
Limor HelpmanDivision of Gynecologic Oncology, McMaster University and The Juravinski Hospital and Cancer Centre, Hamilton, ON, Canada.ORCID 0000-0002-3044-7247
Stephanie ScottDepartment of Gynecology and Obstetrics, Division of Gynecologic Oncology, Dalhousie University, Halifax, NS, Canada.
Christoph WohlmuthDepartment of Obstetrics and Gynecology, Paracelsus Medical University, Salzburg, Austria.
Danielle VicusDepartment of Gynecology and Obstetrics, Division of Gynecologic Oncology, University of Toronto, Toronto, ON, Canada.
Marie PlanteDepartment of Obstetrics, Gynecology and Reproduction, Centre Hospitalier Universitaire de Québec, L'Hôtel-Dieu de Québec, Laval University, Quebec, QC, Canada.
Aline TalhoukDepartment of Molecular Oncology, University of British Columbia, Vancouver, BC, Canada.
David HuntsmanDepartment of Molecular Oncology, University of British Columbia, Vancouver, BC, Canada.
Carlos Parra-HerranDepartment of Laboratory Medicine and Pathobiology University of Toronto and Sunnybrook Health Sciences Centre, Toronto, ON, Canada.ORCID 0000-0003-1420-7291
Mary KinlochDepartment of Pathology and Laboratory Medicine, University of Saskatchewan and Saskatoon City Hospital, Saskatoon, SK, Canada.ORCID 0000-0002-0092-0312
Katherine GrondinPathology Department, Centre Hospitalier Universitaire de Québec at Laval University and L'Hôtel-Dieu de Québec, Quebec, QC, Canada.
C Blake GilksDepartment of Pathology and Laboratory Medicine, University of British Columbia and Vancouver General Hospital, Vancouver, BC, Canada. blake.gilks@vch.ca.
Jessica N McAlpineDepartment of Gynaecology and Obstetrics and Division of Gynaecologic Oncology, University of British Columbia, Vancouver, BC, Canada.
Society of Gynecologic Oncologists of Canada (CoP, Translational Research)
University of British Columbia · CAUniversity of Toronto · CAUniversity of Manitoba · CACentre hospitalier universitaire de Québec · CADalhousie University · CAJewish General Hospital · CAJuravinski Hospital · CAUniversity of Saskatchewan · CAMcMaster University · CAUniversité de Montréal · CAUniversity of Calgary · CACentre Hospitalier de l’Université de Montréal · CAMcGill University · CAUniversité Laval · CAOvarian Cancer Canada · CASaskatoon City Hospital · CASunnybrook Health Science Centre · CAUniversity of Alberta · CAWestern University · CA

Funding

CIHR
6 · The paper itself

Abstract

We assessed the landscape of diagnostic pathology practice and how molecular classification could potentially impact management of patients with endometrial cancer by collecting patient samples, clinicopathologic data, and patient outcomes from EC patients diagnosed in 2016 at 10 Canadian tertiary cancer centers and 19 community hospitals. ProMisE molecular subtype (POLEmut, MMRd, p53abn, No Specific Molecular Profile (NSMP)) was assigned retrospectively. 1357 patients were fully evaluable including 85 POLEmut (6.3%), 380 MMRd (28.0%), 643 NSMP (47.4%), and 249 p53abn ECs (18.3%). Immunohistochemistry (IHC) for MMR proteins was undertaken at the time of primary diagnosis in 2016 in only 42% of the cohort (570/1357; range 3.5-95.4%/center). p53 IHC had only been performed in 21.1% of the cohort (286/1357; range 10.1-41.9%/center). Thus, based on the retrospective molecular subtype assignment, 54.7% (208/380) of MMRd EC had not been tested with MMR IHC (or MSI) and 48.2% (120/249) of p53abn ECs were not tested with p53 IHC in 2016. Molecular subtype diversity within histotypes was profound; most serous carcinomas were p53abn (91.4%), but only 129/249 (51.8%) p53abn EC were serous. Low-grade (Gr1-2) endometrioid carcinomas were mostly NSMP (589/954, 61.7%) but included all molecular subtypes, including p53abn (19/954, 2.0%). Molecular subtype was significantly associated with clinical outcomes (p < 0.001) even in patients with stage I disease (OS p = 0.006, DSS p < 0.001, PFS p < 0.001). Assessment of national pathologic practice in 2016 shows highly variable use of MMR and p53 IHC and demonstrates significant opportunities to improve and standardize biomarker reporting. Inconsistent, non-reflexive IHC resulted in missed opportunities for Hereditary Cancer Program referral and Lynch Syndrome diagnosis, and missed potential therapeutic implications (e.g., chemotherapy in p53abn EC, immune blockade for MMRd EC). Routine integration of molecular subtyping into practice can improve the consistency of EC pathology assessment and classification.

Indexed as

Carcinoma, EndometrioidEndometrial NeoplasmsCanadaDNA Mismatch RepairFemaleHumansRetrospective StudiesTumor Suppressor Protein p53Tumor Suppressor Protein p53

Identifiers

PMID36241860
OpenAlexW4306158070

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.