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BMC Cancer
Published in: BMC Cancer 1/2015

Open Access 01-12-2015 | Study protocol

PIpelle Prospective ENDOmetrial carcinoma (PIPENDO) study, pre-operative recognition of high risk endometrial carcinoma: a multicentre prospective cohort study

Authors: Nicole C. M. Visser, Johan Bulten, Anneke A. M. van der Wurff, Erik A. Boss, Carolien M. Bronkhorst, Harrie W. H. Feijen, Joke E. Haartsen, Hilde A. D. M. van Herk, Ineke M. de Kievit, Paul J. J. M. Klinkhamer, Brenda M. Pijlman, Marc P. M. L. Snijders, Ingrid Vandenput, M. Caroline Vos, Peter E. J. de Wit, Lonneke V. van de Poll-Franse, Leon F.A.G. Massuger, Johanna M. A. Pijnenborg

Published in: BMC Cancer | Issue 1/2015

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Abstract

Background

Endometrial carcinoma is the most common gynaecologic malignancy in industrialised countries and the incidence is still rising. Primary treatment is based on preoperative risk classification and consists in most cases of hysterectomy with bilateral salpingo-oophorectomy. In patients with serous and clear cell histology a complete surgical staging is mandatory. However, in routine clinical practice final histology regularly does not correspond with the preoperative histological diagnosis. This results in both over and under treatment.

Methods/Design

The aim of this multicentre, prospective cohort study is to select a panel of prognostic biomarkers to improve preoperative diagnosis of endometrial carcinoma in order to identify those patients that need extended surgery and/or additional treatment. Additionally, we will determine whether incorporation of cervical cytology and comorbidity could improve this preoperative risk classification. All patients treated for endometrial carcinoma in the participating hospitals from September 2011 till December 2013 are included. Patient characteristics, as well as comorbidity are registered. Patients without preoperative histology, history of hysterectomy and/or endometrial carcinoma or no surgical treatment including hysterectomy are excluded. The preoperative histology and final pathology will be reviewed and compared by expert pathologists. Additional immunohistochemical analysis of IMP3, p53, ER, PR, MLH1, PTEN, beta-catenin, p16, Ki-67, stathmin, ARID1A and L1CAM will be performed. Preoperative histology will be compared with the final pathology results. Follow-up will be at least 24 months to determine risk factors for recurrence and outcome.

Discussion

This study is designed to improve surgical treatment of endometrial carcinoma patients. A total of 432 endometrial carcinoma patients were enrolled between 2011 and 2013. Follow-up will be completed in 2015. Preoperative histology will be evaluated systematically and background endometrium will be classified. This is the first study incorporating immunohistochemistry, cervical cytology and comorbidity to define the optimal panel of prognostic biomarkers that contribute in clinical decision making in the management of endometrial carcinoma.

Trial registration

Netherlands Trial Register number NTR3503
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Metadata
Title
PIpelle Prospective ENDOmetrial carcinoma (PIPENDO) study, pre-operative recognition of high risk endometrial carcinoma: a multicentre prospective cohort study
Authors
Nicole C. M. Visser
Johan Bulten
Anneke A. M. van der Wurff
Erik A. Boss
Carolien M. Bronkhorst
Harrie W. H. Feijen
Joke E. Haartsen
Hilde A. D. M. van Herk
Ineke M. de Kievit
Paul J. J. M. Klinkhamer
Brenda M. Pijlman
Marc P. M. L. Snijders
Ingrid Vandenput
M. Caroline Vos
Peter E. J. de Wit
Lonneke V. van de Poll-Franse
Leon F.A.G. Massuger
Johanna M. A. Pijnenborg
Publication date
01-12-2015
Publisher
BioMed Central
Published in
BMC Cancer / Issue 1/2015
Electronic ISSN: 1471-2407
DOI
https://doi.org/10.1186/s12885-015-1487-3

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