Mismatch repair deficiency predicts worse survival despite adjuvant treatment in stage I endometrial cancer: Opportunities for novel adjuvant therapy

Abstract

Objective: In contrast to other common cancers, the annual mortality from endometrial cancer is increasing. There are few reliable biomarkers to identify early-stage patients at risk for recurrence who might benefit from adjuvant therapy. This is a clinically important gap in knowledge, as many endometrial cancer recurrences outside the vaginal cuff are incurable. Mismatch repair deficiency (dMMR) secondary to MLH1 methylation and subsequent loss of MLH1 protein is one of the most common molecular events in endometrioid endometrial carcinoma, occurring in 15%–20% of cases.