Distribution of genetic alterations in high-risk early-stage cervical cancer patients treated with postoperative radiation therapy

• Published in: Scientific reports Vol. 11; no. 1; p. 10567
• Main Authors: Murakami, Naoya, Asami, Yuka, Yoshida, Hiroshi, Takayanagi, Daisuke, Hirose, Sou, Kuno, Ikumi, Takahashi, Kazuaki, Matsuda, Maiko, Shimada, Yoko, Yamano, Shotaro, Sunami, Kuniko, Honda, Takayuki, Nakahara, Tomomi, Watanabe, Tomoko, Okuma, Kae, Kuroda, Takafumi, Kohno, Takashi, Kato, Tomoyasu, Shiraishi, Kouya, Itami, Jun
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 19.05.2021; Nature Publishing Group; Nature Portfolio
• Subjects: 631/61/212; 631/67; 631/67/1059/485; 631/67/1517/1371; 631/67/2329; 631/67/395; Cervical cancer; Genetic analysis; Humanities and Social Sciences; Hysterectomy; Lymph nodes; Metastases; multidisciplinary; Mutation; Paraffin; Precision medicine; Radiation therapy; Science; Science (multidisciplinary); Survival; Uterine cancer; Uterus; Vagina
• ISSN: 2045-2322; 2045-2322
• DOI: 10.1038/s41598-021-90139-0

Somatic genetic alteration analysis was performed for post-hysterectomy high-risk early-stage uterine cervical cancer patients who underwent post-operative radiation therapy. Post-operative radiation therapy was performed for patients with pathological features of pelvic lymph node metastasis, parametrium invasion, or positive vaginal margin, which corresponded to the post-operative high-risk category. DNA was extracted from paraffin-embedded surgical specimens, and 50 somatic hotspot genetic alternations were detected using Ion AmpliSeq Cancer Hotspot Panel. The existence of actionable mutation was assessed based on OncoKB evidence level > 3A. Between January 2008 and November 2019, 89 patients who underwent abdominal radical hysterectomy followed by post-operative radiation therapy were identified. The follow-up period for living patients was 82.3 months (range 9.3–153.9), and the 5-year relapse-free survival and overall survival rates were 72.6% and 85.9%, respectively. The most frequently detected somatic mutation was PIK3CA (26 [29.2%] patients); however, no prognostic somatic genetic alterations were identified. Actionable mutations were detected in 30 (33.7%) patients. Actionable mutations were detected in approximately one-third of patients, suggesting that precision medicine can be offered to patients with post-operative high-risk uterine cervical cancer in the near future.