Abstract
The aim of this article is to propose guidelines and recommendations in problematic areas in pathologic reporting of endometrial carcinoma (EC) regarding special techniques and ancillary studies. An organizing committee designed a comprehensive survey with different questions related to pathologic features, diagnosis, and prognosis of EC that was sent to all members of the International Society of Gynecological Pathologists. The special techniques/ancillary studies group received 4 different questions to be addressed. Five members of the group reviewed the literature and came up with recommendations and an accompanying text which were discussed and agreed upon by all members of the group. Twelve different recommendations are made. They address the value of immunohistochemistry, ploidy, and molecular analysis for assessing prognosis in EC, the value of steroid hormone receptor analysis to predict response to hormone therapy, and parameters regarding applying immunohistochemistry and molecular tests for assessing mismatch deficiency in EC.
Highlights
Several biomarkers have been proposed to better assess the prognosis and prediction of response to therapy and to identify patients carrying germline mutations associated with an increased risk of endometrial carcinoma (EC) [1]
We provide guidelines, which have been produced after a thorough literature search, and discussed among a group of members of the International Society of Gynecological Pathologists (ISGyP), selected because of their expertise in the immunohistochemistry (IHC) and molecular pathology of EC
In addition to the The Cancer Genome Atlas (TCGA) approach, several groups have assessed the usefulness of next-generation sequencing in differential diagnosis between different types of tumors, endometrioid carcinoma (EEC) and serous carcinoma (SC) [25]
Summary
Endometrial carcinoma (EC) is the fourth most common cancer among women, with an estimated incidence of 10 to 20 per 100,000 women. The prognosis is favorable for patients with low-grade tumors and early-stage disease, the outcomes for patients with high-grade and/or advanced stage tumors remains relatively poor. Following surgery (which is the usual treatment), patients with tumors with a high risk of recurrence often receive adjuvant radiotherapy, chemotherapy, and/or hormone therapy. Traditional chemotherapeutic regimes are less effective in comparison with cancers of other organs, which emphasize the importance of identifying new molecular targets. Several biomarkers have been proposed to better assess the prognosis and prediction of response to therapy and to identify patients carrying germline mutations associated with an increased risk of EC [1]. We provide guidelines, which have been produced after a thorough literature search, and discussed among a group of members of the International Society of Gynecological Pathologists (ISGyP), selected because of their expertise in the immunohistochemistry (IHC) and molecular pathology of EC
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