{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,19]],"date-time":"2026-04-19T06:27:07Z","timestamp":1776580027034,"version":"3.51.2"},"reference-count":36,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2024,12,13]],"date-time":"2024-12-13T00:00:00Z","timestamp":1734048000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Oncol."],"abstract":"<jats:sec><jats:title>Purpose<\/jats:title><jats:p>Molecular classification of endometrial cancer (EC) has emerged as a key approach to individualize therapy and define prognostic outcomes. This study aimed to implement the traditional ProMisE classification in a Brazilian population, compared with a molecular setting of ProMisE biomarkers, and evaluate its impact on patients\u2019 prognosis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Patient and methods<\/jats:title><jats:p>A prospective cohort of 114 patients with primary EC treated at Barretos Cancer Hospital (BCH) between October 2020 and December 2022 was conducted. Pathology diagnosis, staging, treatment, and follow-up data were collected. The traditional ProMisE methodology was carried out by <jats:italic>POLE<\/jats:italic> hotspot sequencing and immunohistochemistry (IHC) for p53 and mismatch repair (MMR) proteins. We further evaluate the MMR and <jats:italic>TP53<\/jats:italic> status by molecular approach, namely microsatellite instability (MSI) by PCR-based and <jats:italic>TP53<\/jats:italic> mutation analysis by next-generation sequencing (NGS). The results of the 4 molecular groups in both methodologies were compared regarding agreement accuracy and survival outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among the 114 cases, the traditional ProMisE groups were: <jats:italic>POLE<\/jats:italic>mut 15.8%, MMRd 28.1%, p53abn 27.2%, and no specific molecular profile (NSMP) 28.9%. Considering the molecular classification approach, we observed a <jats:italic>POLE<\/jats:italic>mut group <jats:italic>of 15.8%<\/jats:italic>, MSI group of 23.7%, <jats:italic>TP53<\/jats:italic> mutation of 27.2%, and NSMP of 33.3%. The concordance rate of both approaches was 86.8% (99\/114 cases) with an overall accuracy of 0.87. Importantly, both traditional and molecular ProMisE approaches were associated with significant distinct overall survival (OS) and progression-free survival (PFS) outcomes, with <jats:italic>POLE<\/jats:italic>mut patients exhibiting a better prognosis (93.8% OS, at 24 months), whereas the p53abn having a worse survival time (68.9% of OS, at 24 months).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>We reported for the first time the Brazilian profile of the ProMisE classification of endometrial cancer and demonstrated the prognostic impact of the traditional and molecular ProMisE classification on patient outcomes.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fonc.2024.1503901","type":"journal-article","created":{"date-parts":[[2024,12,13]],"date-time":"2024-12-13T05:11:01Z","timestamp":1734066661000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":5,"title":["Implementation of the ProMisE classifier and 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