{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T13:03:51Z","timestamp":1785157431557,"version":"3.55.0"},"reference-count":25,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T00:00:00Z","timestamp":1785110400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Curr. Oncol.","Current Oncology"],"abstract":"<jats:p>Objective: To examine survival outcomes and identify clinicopathological factors associated with survival in patients with advanced-stage endometrial cancer who received neoadjuvant chemotherapy before interval debulking surgery (NACT-IDS). Methods: A single-center retrospective cohort study was conducted of patients who were diagnosed with advanced-stage (2009 FIGO IIIB, IIIC, IV) endometrial cancer (2012\u20132024) and underwent NACT-IDS. Tumor response to NACT was determined with computed tomography and the RECIST criteria, and demographic, clinicopathologic, perioperative, and tumor molecular features (mismatch repair protein [MMR] status and p53 pattern) were collected from medical chart review. Association between tumor molecular features and response to NACT was determined. Primary endpoints were progression-free and overall survival, analyzed with univariate Cox and stratified Kaplan\u2013Meier analysis. Results: Of 42 consecutive patients (median age of 68 years), the majority (n = 26; 61.9%) had a partial tumor response to NACT, with only five (11.9%) having a complete response, four (9.5%) having stable disease, and seven (16.7%) having progressive disease. Most cases had no residual tumor after IDS (n = 35; 83.3%). MMR protein status was associated with the tumor response to NACT (p = 0.013), but p53 status was not. During follow-up, 24 patients died (57.1%), and 31 (73.8%) died or had disease progression. Tumor response to NACT and resection margin status were associated with progression-free survival in unadjusted analyses, but no covariate adjustment was possible with limited sample size. Conclusions: This study highlights MMR-deficiency, response to NACT, and surgical resection status as clinicopathologic features of interest for future studies of prognostic factors and alternative therapies in advanced-stage endometrial cancer.<\/jats:p>","DOI":"10.3390\/curroncol33080448","type":"journal-article","created":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T11:54:26Z","timestamp":1785153266000},"page":"448","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Neoadjuvant Chemotherapy Followed by Interval Debulking for Advanced-Stage Endometrial Cancer: Survival Outcome Based on Surgical and Molecular Characteristics"],"prefix":"10.3390","volume":"33","author":[{"given":"Mira","family":"Kheil","sequence":"first","affiliation":[{"name":"Department of Obstetrics & Gynecology, Henry Ford Health, Detroit, MI 48202, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tariq","family":"Mekkaoui","sequence":"additional","affiliation":[{"name":"Department of Obstetrics & Gynecology, Henry Ford Health, Detroit, MI 48202, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emily","family":"Andresan","sequence":"additional","affiliation":[{"name":"School of Medicine, Michigan State University, Detroit, MI 48201, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-2940-4917","authenticated-orcid":false,"given":"Gloria","family":"Fung","sequence":"additional","affiliation":[{"name":"School of Medicine, Wayne State University, Detroit, MI 48201, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-3287-0170","authenticated-orcid":false,"given":"Madison","family":"Miller","sequence":"additional","affiliation":[{"name":"Department of Gynecologic Oncology, New York Presbyterian\/Columbia University Irving Medical Center, New York, NY 10032, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jamie G.","family":"Joseph","sequence":"additional","affiliation":[{"name":"Department of Public Health & Epidemiology, Henry Ford Health, Detroit, MI 48202, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anqi","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Public Health & Epidemiology, Henry Ford Health, Detroit, MI 48202, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ali","family":"Al Asadi","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Henry Ford Health, Detroit, MI 48202, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamed","family":"Elshaikh","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Henry Ford Health, Detroit, MI 48202, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5180-0409","authenticated-orcid":false,"given":"Sarfraz","family":"Ahmad","sequence":"additional","affiliation":[{"name":"Gynecologic Oncology Program, AdventHealth Cancer Institute, Orlando, FL 32804, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmad","family":"Awada","sequence":"additional","affiliation":[{"name":"Department of Gynecologic Oncology, Henry Ford Health, Detroit, MI 48202, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,7,27]]},"reference":[{"key":"ref_1","unstructured":"(2026, April 06). Key Statistics for Endometrial Cancer|American Cancer Society. Available online: https:\/\/www.cancer.org\/cancer\/types\/endometrial-cancer\/about\/key-statistics.html."},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Seo, J.H., Kim, S.M., Lee, Y.Y., Kim, T.J., Lee, J.W., Kim, B.G., and Choi, C.J. (2025). Improved prognostic stratification with the FIGO 2023 staging system in endometrial cancer: Real-world validation in 2969 patients. Cancers, 17.","DOI":"10.3390\/cancers17172871"},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Capozzi, V.A., Scarpelli, E., De Finis, A., Rotondella, I., Scebba, D., Gallinelli, A., Montrucchio, C., Martignon, G., Leotta, M., and Ghi, T. (2023). Optimal management for stage IVB endometrial cancer: A systematic review. Cancers, 15.","DOI":"10.3390\/cancers15215123"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"113316","DOI":"10.1016\/j.ejca.2023.113316","article-title":"Validation of the 2023 FIGO staging schema for advanced endometrial cancer","volume":"193","author":"Matsuo","year":"2023","journal-title":"Eur. J. Cancer"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1016\/j.ygyno.2010.04.005","article-title":"Cytoreductive surgery for advanced or recurrent endometrial cancer: A meta-analysis","volume":"118","author":"Barlin","year":"2010","journal-title":"Gynecol. Oncol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"574","DOI":"10.1016\/j.ygyno.2013.08.036","article-title":"Status of treatment for the overall population of patients with stage IVb endometrial cancer, and evaluation of the role of preoperative chemotherapy: A retrospective multi-institutional study of 426 patients in Japan","volume":"131","author":"Eto","year":"2013","journal-title":"Gynecol. Oncol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1136\/ijgc-2020-002230","article-title":"ESGO\/ESTRO\/ESP guidelines for the management of patients with endometrial carcinoma","volume":"31","author":"Concin","year":"2021","journal-title":"Int. J. Gynecol. Cancer"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"284","DOI":"10.6004\/jnccn.2025.0038","article-title":"NCCN Guidelines\u00ae Insights: Uterine Neoplasms, Version 3.2025: Featured Updates to the NCCN Guidelines\u00ae","volume":"23","author":"Campos","year":"2025","journal-title":"J. Natl. Compr. Canc Netw."},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Restaino, S., Paglietti, C., Arcieri, M., Biasioli, A., Della Martina, M., Mariuzzi, L., Andreetta, C., Titone, F., Bogani, G., and Raimondo, D. (2023). Management of patients diagnosed with endometrial cancer: Comparison of guidelines. Cancers, 5.","DOI":"10.3390\/cancers15041091"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"e2028612","DOI":"10.1001\/jamanetworkopen.2020.28612","article-title":"Association of neoadjuvant chemotherapy with overall survival in women with metastatic endometrial cancer","volume":"3","author":"Tobias","year":"2020","journal-title":"JAMA Netw. Open"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"436","DOI":"10.1007\/s10147-022-02284-9","article-title":"JGOG2046: A feasibility study of neoadjuvant chemotherapy followed by debulking surgery for clinically diagnosed FIGO stage IVb endometrial cancer","volume":"28","author":"Nakanishi","year":"2023","journal-title":"Int. J. Clin. Oncol."},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Ronsini, C., Iavarone, I., Carotenuto, A., Raffone, A., Andreoli, G., Napolitano, S., De Franciscis, P., Ambrosio, D., and Cobellis, L. (2024). Now or Later? The Role of Neoadjuvant Treatment in Advanced Endometrial Cancer: A Systematic Review. Healthcare, 12.","DOI":"10.3390\/healthcare12232404"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"113958","DOI":"10.1016\/j.ejogrb.2025.113958","article-title":"Upfront and interval debulking surgery in advanced\/metastatic endometrial cancer in the era of molecular classification","volume":"310","author":"Caiazzo","year":"2025","journal-title":"Eur. J. Obstet. Gynecol. Reprod. Biol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"428","DOI":"10.1016\/j.ygyno.2022.03.021","article-title":"Population-level uptake of neoadjuvant chemotherapy for stage IVB endometrial cancer","volume":"165","author":"Jooya","year":"2022","journal-title":"Gynecol. Oncol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"228","DOI":"10.1016\/j.ejca.2008.10.026","article-title":"New response evaluation criteria in solid tumors: Revised RECIST guideline (version 1.1)","volume":"45","author":"Eisenhauer","year":"2009","journal-title":"Eur. J. Cancer"},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Lim, H., Bang, S.H., Kim, Y., Cho, S.H., Shin, W., Kim, S.I., Kim, T.H., Suh, D.H., Lim, M.C., and Kim, J.W. (2022). Clinical implications of neoadjuvant chemotherapy in advanced endometrial cancer: A multi-center retrospective cohort study. BMC Cancer, 22.","DOI":"10.1186\/s12885-022-09746-3"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"100887","DOI":"10.1016\/j.gore.2021.100887","article-title":"Neoadjuvant chemotherapy for advanced stage endometrial cancer: A systematic review","volume":"38","author":"Huang","year":"2021","journal-title":"Gynecol. Oncol. Rep."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"281","DOI":"10.1007\/s00280-019-03838-x","article-title":"Neoadjuvant chemotherapy in patients with advanced endometrial cancer","volume":"84","author":"Khouri","year":"2019","journal-title":"Cancer Chemother. Pharmacol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"26","DOI":"10.1016\/j.ejogrb.2018.11.029","article-title":"Advanced stage (IIIC\/IV) endometrial cancer: Role of cytoreduction and determinants of survival","volume":"234","author":"Rajkumar","year":"2019","journal-title":"Eur. J. Obstet. Gynecol. Reprod. Biol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"237.E1","DOI":"10.1016\/j.ajog.2021.04.254","article-title":"Primary cytoreductive surgery for advanced stage endometrial cancer: A systematic review and meta-analysis","volume":"225","author":"Albright","year":"2021","journal-title":"Am. J. Obstet. Gynecol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"102015","DOI":"10.1016\/j.ijgc.2025.102015","article-title":"Impact of surgery and molecular classification in stage IV endometrial cancer","volume":"35","author":"Loverro","year":"2025","journal-title":"Int. J. Gynecol. Cancer"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"608","DOI":"10.1016\/j.ygyno.2011.05.020","article-title":"Surgical cytoreduction in stage IV endometrioid endometrial carcinoma","volume":"122","author":"Shih","year":"2011","journal-title":"Gynecol. Oncol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"102784","DOI":"10.1016\/j.ijgc.2025.102784","article-title":"The role of neoadjuvant chemotherapy in clinically advanced endometrial cancer: A real-world retrospective single-institutional study","volume":"36","author":"Padival","year":"2026","journal-title":"Int. J. Gynecol. Cancer"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"1204","DOI":"10.5858\/arpa.2022-0166-RA","article-title":"Recent advances in the classification of gynecological tract tumors: Updates from the 5th edition of the World Health Organization \u201cBlue Book\u201d","volume":"147","author":"Parkash","year":"2023","journal-title":"Arch. Pathol. Lab. Med."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"847","DOI":"10.1136\/ijgc-2023-005058","article-title":"Prognostic value of molecular classification in stage IV endometrial cancer","volume":"34","author":"Uijterwaal","year":"2024","journal-title":"Int. J. Gynecol. 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