The ProMisE molecular classifier for endometrial cancer identifies four groups. Which molecular group carries the BEST prognosis and may not require adjuvant therapy after complete staging surgery for stage I–II disease?
- A MMR-deficient (dMMR)
- B p53 mutant (TP53 abnormal)
- C POLE ultra-mutated ✓
- D No specific molecular profile (NSMP)
Correct answer: C. POLE ultra-mutated
Explanation
POLE ultra-mutated endometrial carcinomas have an excellent prognosis regardless of traditional grade or stage, with very low recurrence rates. Current evidence supports omission of adjuvant radiotherapy in POLE-mutated stage I–II endometrial cancer after complete staging. p53-mutant tumours have the worst prognosis. MMR-deficient tumours have intermediate to favourable prognosis and are immunotherapy targets. NSMP is the reference category.
Reference: Shaw's Textbook of Gynaecology, 17th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.