Prognostic significance of hormone receptor (ER/PR) status in endometrial carcinoma in black women: implications with lymph node metastasis

Objective: Integrating ER/PR receptors into clinical risk stratification is still under investigation and is proving to be an important component in endometrial cancer management. This study aimed to investigate the prognostic value of ER/PR receptors specifically its correlation with lymph node metastasis in black women which form a vulnerable group associated with poor outcomes. Methods: We reviewed black females (n = 70) diagnosed with endometrial cancer at our institution from 2015–2018 including endometroid/non-endometroid histology, FIGO stage I–IVA, grade 1–3 for ER/PR receptors and presence or absence of pelvic lymph nodes based on preoperative endometrial curettage and post-surgical pathology specimens. Results: Majority of our patients were postmenopausal (59 out of 70) 84%. FIGO stage 1 and 2 constituted 72% (50 out of 70). Endometroid histology constituted 39 out of 70 (55%) cases and non-endometroid histology which includes serous, clear cell and carcinosarcomas constituted 45% of the cases. Loss of estrogen receptor (ER-) was observed in 19 of 70 patients (27%) and loss of progesterone receptor (PR-) was seen in 22 patients (31%) which was significantly associated with lymph node metastasis (p $<$ 0.05). Subgroup analyses showed a significant association between PR+ and absence of lymph node metastasis in cases of endometrioid cancer (p $<$ 0.05). Nevertheless, there was no statistically significant association (p = 0.10) between ER receptors and lymph node metastasis in patients with endometrioid cancer. In non-endometrioid histology both ER- and PR- were found to be statistically significantly associated with lymph node involvement. Conclusion: Loss of ER and PR receptors independently predicts lymph node metastasis in endometrial cancers in black women.

Cancer; Receptors; Endometrium

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