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DNA Defects Predict Endometrial Ca Prognosis

DNA Defects Predict Endometrial Ca Prognosis

SAN FRANCISCO--A retrospective study of 61 endometrial cancers,
collected from patients at the City of Hope Hospital, Duarte,
Calif, found that approximately 49% of the tumors had some type
of DNA abnormality, Kristi Van Nostrand, MD, reported at the American
College of Obstetricians and Gynecologists (ACOG) annual clinical

The 5-year survival rate for the entire cohort was 83%. The most
common mutations were c-myc amplification and p53 mutations, and
patients with these tumors had the poorest survival rates.

K-ras mutations and HER-2/neu amplification were the next most
common, and those patients with HER-2/neu amplification had a
better survival rate than the rest of the group.

"A lot of studies have looked at a variety of these mutations,
but none has looked for all four of the most common mutations
at the same time," said Dr. Van Nostrand, a gynecology/oncology
fellow at the University of California at Irvine.

The California researchers found that HER-2/neu and K-ras abnormalities
tended to be seen in low-grade, low-stage tumors, leading them
to believe that they are early occurrences in tumorigenicity.
The c-myc and p53 abnormalities were seen in higher-grade, higher-stage,
poor prognosis tumors.

Overall, the patients with abnormalities tended to he older, but
there were significant differences among patients with different
abnormalities. On average, patients with K-ras mutations were
older, while those with HER-2/neu amplification tended to be younger.

The researchers found five tumors that had more than one mutation,
Dr. Van Nostrand reported. The patients with these tumors had
a comparable, if not better, survival rate than the other patients.
Thus, it appears that progressive accumulation of these different
mutations does not add up to poor prognostic tumors, she said.
The majority of the tumors with more than one mutation had p53
mutations, and HER-2/neu was the abnormality most often associated
with another mutation.


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