Gynecology and Obstetrics Clinical Medicine (Mar 2021)
BRCA1/2 mutations and survival of high-grade endometrioid endometrial cancer
Abstract
Background: BRCA1/2 mutations have been shown to be associated with the development of many solid tumors including endometrial cancer (EC). The objectives of this study are to analyze the association between BRCA1/2 mutational status and clinicopathological characteristics as well as outcomes in EC patients. Methods: 510 eligible EC patients from the Cancer Genome Atlas database were included in the study. The association between clinicopathological characteristics and different BRCA1/2 mutational status was compared and analyzed. Analyses of the impact of BRCA mutations on survival in EC patients was conducted using Kaplan-Meier survival analyses and Cox regressions. In order to control confounding bias between groups, propensity score matching method was used. Results: Among the eligible patients, 11 (2.2%) harbored BRCA1 mutation, 43 (8.4%) harbored BRCA2 mutation, and 36 (7.1%) harbored both. Body mass index, rates of hypertension history, proportion of non-endometrioid histology and rates of positive peritoneal cytology were lower in patients with BRCA1/2 mutations compared with the group of wild-type counterpart (p = 0.020, 0.048, 0.001 and 0.012, respectively). Patients with BRCA1/2 mutations showed longer overall (OS) and recurrence-free survival (RFS) (in Kaplan-Meier analyses, p < 0.001 and p = 0.004, respectively; in Cox regressions, p = 0.001 and 0.007, respectively). Further analyses showed that the impact of BRCA mutations on survival was significant only in patients with high-grade endometrioid EC. Based on the cohorts generated after propensity score matching, in high-grade endometrioid EC patients, the influence of BRCA1/2 mutations remained significant on OS, but not on RFS (p = 0.003 and 0.057 in Kaplan-Meier analyses, p = 0.020 and 0.071 in Cox regressions). Conclusion: BRCA1/2 mutations are associated with better survival in patients with high grade endometrioid EC, indicating the value of BRCA testing in EC clinical management.
