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Center","award":["W81XWH-05-2-0005","W81XWH-9-2-0051","W81XWH-10-2-0018","W81XWH-11-2-0131","HU0001-16-2-0006","HU0001-21-2-0027","CA114793","CA27469","CA37517","1U10 CA180822","U10CA180868"],"award-info":[{"award-number":["W81XWH-05-2-0005","W81XWH-9-2-0051","W81XWH-10-2-0018","W81XWH-11-2-0131","HU0001-16-2-0006","HU0001-21-2-0027","CA114793","CA27469","CA37517","1U10 CA180822","U10CA180868"]}]},{"name":"NRG Oncology","award":["W81XWH-05-2-0005","W81XWH-9-2-0051","W81XWH-10-2-0018","W81XWH-11-2-0131","HU0001-16-2-0006","HU0001-21-2-0027","CA114793","CA27469","CA37517","1U10 CA180822","U10CA180868"],"award-info":[{"award-number":["W81XWH-05-2-0005","W81XWH-9-2-0051","W81XWH-10-2-0018","W81XWH-11-2-0131","HU0001-16-2-0006","HU0001-21-2-0027","CA114793","CA27469","CA37517","1U10 CA180822","U10CA180868"]}]},{"name":"NRG Operations","award":["W81XWH-05-2-0005","W81XWH-9-2-0051","W81XWH-10-2-0018","W81XWH-11-2-0131","HU0001-16-2-0006","HU0001-21-2-0027","CA114793","CA27469","CA37517","1U10 CA180822","U10CA180868"],"award-info":[{"award-number":["W81XWH-05-2-0005","W81XWH-9-2-0051","W81XWH-10-2-0018","W81XWH-11-2-0131","HU0001-16-2-0006","HU0001-21-2-0027","CA114793","CA27469","CA37517","1U10 CA180822","U10CA180868"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>Objectives: A risk assessment model for metastasis in endometrioid endometrial cancer (EEC) was developed using molecular and clinical features, and prognostic association was examined. Methods: Patients had stage I, IIIC, or IV EEC with tumor-derived RNA-sequencing or microarray-based data. Metastasis-associated transcripts and platform-centric diagnostic algorithms were selected and evaluated using regression modeling and receiver operating characteristic curves. Results: Seven metastasis-associated transcripts were selected from analysis in the training cohorts using 10-fold cross validation and incorporated into an MS7 classifier using platform-specific coefficients. The predictive accuracy of the MS7 classifier in Training-1 was superior to that of other clinical and molecular features, with an area under the curve (95% confidence interval) of 0.89 (0.80\u20130.98) for MS7 compared with 0.69 (0.59\u20130.80) and 0.71 (0.58\u20130.83) for the top evaluated clinical and molecular features, respectively. The performance of MS7 was independently validated in 245 patients using RNA sequencing and in 81 patients using microarray-based data. MS7 + MI (myometrial invasion) was preferrable to individual features and exhibited 100% sensitivity and negative predictive value. The MS7 classifier was associated with lower progression-free and overall survival (p \u2264 0.003). Conclusion: A risk assessment classifier for metastasis and prognosis in EEC patients with primary tumor derived MS7 + MI is available for further development and optimization as a companion clinical support tool.<\/jats:p>","DOI":"10.3390\/cancers14174070","type":"journal-article","created":{"date-parts":[[2022,8,23]],"date-time":"2022-08-23T21:05:12Z","timestamp":1661288712000},"page":"4070","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Improving Risk Assessment for Metastatic Disease in Endometrioid Endometrial Cancer Patients Using Molecular and Clinical Features: An NRG Oncology\/Gynecologic Oncology Group Study"],"prefix":"10.3390","volume":"14","author":[{"given":"Yovanni","family":"Casablanca","sequence":"first","affiliation":[{"name":"Gynecologic Cancer Center of Excellence, Department of Gynecologic Surgery and Obstetrics, Uniformed Services University of the Health Sciences, Walter Reed National Military Medical Center, Bethesda, MD 20889, USA"}]},{"given":"Guisong","family":"Wang","sequence":"additional","affiliation":[{"name":"Gynecologic Cancer Center of Excellence, Department of Gynecologic Surgery and Obstetrics, Uniformed Services University of the Health Sciences, Walter Reed National Military Medical Center, Bethesda, MD 20889, USA"},{"name":"The Henry M Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, MD 20817, USA"}]},{"given":"Heather A.","family":"Lankes","sequence":"additional","affiliation":[{"name":"Gynecologic Oncology Group Statistical and Data Management Center, Roswell Park Comprehensive Cancer Center, Buffalo, NY 14263, USA"}]},{"given":"Chunqiao","family":"Tian","sequence":"additional","affiliation":[{"name":"Gynecologic Cancer Center of Excellence, Department of Gynecologic Surgery and Obstetrics, Uniformed Services University of the Health Sciences, Walter Reed National Military Medical Center, Bethesda, MD 20889, USA"},{"name":"The Henry M Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, MD 20817, USA"}]},{"given":"Nicholas W.","family":"Bateman","sequence":"additional","affiliation":[{"name":"Gynecologic Cancer Center of Excellence, Department of Gynecologic Surgery and Obstetrics, Uniformed Services University of the Health Sciences, Walter Reed National Military Medical Center, Bethesda, MD 20889, USA"},{"name":"The Henry M Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, MD 20817, USA"}]},{"given":"Caela R.","family":"Miller","sequence":"additional","affiliation":[{"name":"Gynecologic Cancer Center of Excellence, Department of Gynecologic Surgery and Obstetrics, Uniformed Services University of the Health Sciences, Walter Reed National Military Medical Center, Bethesda, MD 20889, USA"}]},{"given":"Nicole P.","family":"Chappell","sequence":"additional","affiliation":[{"name":"Gynecologic Cancer Center of Excellence, Department of Gynecologic Surgery and Obstetrics, Uniformed Services University of the Health Sciences, Walter Reed National Military Medical Center, Bethesda, MD 20889, USA"}]},{"given":"Laura J.","family":"Havrilesky","sequence":"additional","affiliation":[{"name":"Division of Gynecologic Oncology, Duke University, Durham, NC 27710, USA"}]},{"given":"Amy Hooks","family":"Wallace","sequence":"additional","affiliation":[{"name":"Division of Gynecologic Oncology, Duke University, Durham, NC 27710, USA"}]},{"given":"Nilsa C.","family":"Ramirez","sequence":"additional","affiliation":[{"name":"Gynecologic Oncology Group Tissue Bank, Nationwide Children\u2019s Hospital, Columbus, OH 43205, USA"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8215-5887","authenticated-orcid":false,"given":"David S.","family":"Miller","sequence":"additional","affiliation":[{"name":"Division of Gynecologic Oncology, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA"}]},{"given":"Julie","family":"Oliver","sequence":"additional","affiliation":[{"name":"Gynecologic Cancer Center of Excellence, Department of Gynecologic Surgery and Obstetrics, Uniformed Services University of the Health Sciences, Walter Reed National Military Medical Center, Bethesda, MD 20889, USA"},{"name":"The Henry M Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, MD 20817, USA"}]},{"given":"Dave","family":"Mitchell","sequence":"additional","affiliation":[{"name":"Gynecologic Cancer Center of Excellence, Department of Gynecologic Surgery and Obstetrics, Uniformed Services University of the Health Sciences, Walter Reed National Military Medical Center, Bethesda, MD 20889, USA"},{"name":"The Henry M Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, MD 20817, USA"}]},{"given":"Tracy","family":"Litzi","sequence":"additional","affiliation":[{"name":"Gynecologic Cancer Center of Excellence, Department of Gynecologic Surgery and Obstetrics, Uniformed Services University of the Health Sciences, Walter Reed National Military Medical Center, Bethesda, MD 20889, USA"},{"name":"The Henry M Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, MD 20817, USA"}]},{"given":"Brian E.","family":"Blanton","sequence":"additional","affiliation":[{"name":"Gynecologic Cancer Center of Excellence, Department of Gynecologic Surgery and Obstetrics, Uniformed Services University of the Health Sciences, Walter Reed National Military Medical Center, Bethesda, MD 20889, USA"},{"name":"The Henry M Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, MD 20817, USA"}]},{"given":"William J.","family":"Lowery","sequence":"additional","affiliation":[{"name":"Gynecologic Cancer Center of Excellence, Department of Gynecologic Surgery and Obstetrics, Uniformed Services University of the Health Sciences, Walter Reed National Military Medical Center, Bethesda, MD 20889, USA"}]},{"given":"John I.","family":"Risinger","sequence":"additional","affiliation":[{"name":"Department of Obstetrics, Gynecology and Reproductive Biology, Michigan State University, 333 Bostwick Ave., NE, Grand Rapids, MI 49503, USA"}]},{"given":"Chad A.","family":"Hamilton","sequence":"additional","affiliation":[{"name":"Gynecologic Cancer Center of Excellence, Department of Gynecologic Surgery and Obstetrics, Uniformed Services University of the Health Sciences, Walter Reed National Military Medical Center, Bethesda, MD 20889, USA"},{"name":"Women\u2019s Health Integrated Research Center, Women\u2019s Service Line, Inova Health System, Falls Church, VA 22042, USA"}]},{"given":"Neil T.","family":"Phippen","sequence":"additional","affiliation":[{"name":"Gynecologic Cancer Center of Excellence, Department of Gynecologic Surgery and Obstetrics, Uniformed Services University of the Health Sciences, Walter Reed National Military Medical Center, Bethesda, MD 20889, USA"},{"name":"Women\u2019s Health Integrated Research Center, Women\u2019s Service Line, Inova Health System, Falls Church, VA 22042, USA"}]},{"given":"Thomas P.","family":"Conrads","sequence":"additional","affiliation":[{"name":"Gynecologic Cancer Center of Excellence, Department of Gynecologic Surgery and Obstetrics, Uniformed Services University of the Health Sciences, Walter Reed National Military Medical Center, Bethesda, MD 20889, USA"},{"name":"Women\u2019s Health Integrated Research Center, Women\u2019s Service Line, Inova Health System, Falls Church, VA 22042, USA"}]},{"given":"David","family":"Mutch","sequence":"additional","affiliation":[{"name":"Division of Gynecologic Oncology, Washington University, St. Louis, MO 63110, USA"}]},{"given":"Katherine","family":"Moxley","sequence":"additional","affiliation":[{"name":"Department of OB\/GYN, Section of Gyn Oncology, University of Oklahoma University Health Sciences Center, Oklahoma City, OK 73104, USA"}]},{"given":"Roger B.","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of GYN\/ONC, Tacoma General Hospital, Tacoma, WA 98405, USA"}]},{"given":"Floor","family":"Backes","sequence":"additional","affiliation":[{"name":"Division of Gynecologic Oncology, Ohio State University Comprehensive Cancer Center, Columbus, OH 43210, USA"}]},{"given":"Michael J.","family":"Birrer","sequence":"additional","affiliation":[{"name":"P. Rockefeller Cancer Institute, Women\u2019s Gynecologic Cancer Clinic, Little Rock, AR 72205, USA"}]},{"given":"Kathleen M.","family":"Darcy","sequence":"additional","affiliation":[{"name":"Gynecologic Cancer Center of Excellence, Department of Gynecologic Surgery and Obstetrics, Uniformed Services University of the Health Sciences, Walter Reed National Military Medical Center, Bethesda, MD 20889, USA"},{"name":"The Henry M Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, MD 20817, USA"}]},{"given":"George Larry","family":"Maxwell","sequence":"additional","affiliation":[{"name":"Gynecologic Cancer Center of Excellence, Department of Gynecologic Surgery and Obstetrics, Uniformed Services University of the Health Sciences, Walter Reed National Military Medical Center, Bethesda, MD 20889, USA"},{"name":"Women\u2019s Health Integrated Research Center, Women\u2019s Service Line, Inova Health System, Falls Church, VA 22042, USA"}]}],"member":"1968","published-online":{"date-parts":[[2022,8,23]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"7","DOI":"10.3322\/caac.21708","article-title":"Cancer statistics, 2022","volume":"72","author":"Siegel","year":"2022","journal-title":"CA Cancer J. 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