title: L1CAM is an independent predictor of poor survival in endometrial cancer - An analysis of The Cancer Genome Atlas (TCGA).
abstract: L1-cell adhesion molecule (L1CAM) was previously reported to carry a poor prognosis in Stage I, low-risk endometrial cancer (EC). We evaluated the role of L1CAM among all stages and histologies in ECs in The Cancer Genome Atlas (TCGA).
  
  
  
  Clinical information and RNA-Seq expression data were derived from TCGA uterine cancer cohort. Associations between L1CAM expression and clinical factors were tested with linear and logistic regression. Differences in survival between "high" and "low" expression groups (defined by median expression) of L1CAM were compared using Cox regression analysis, with p-values calculated via log-rank test. Kaplan-Meier curves were tested with the log-rank test.
  
  
  
  Patient characteristics of 545 primary tumors with RNA-Seq gene expression data were analyzed. Median age was 64years (range 31-90). Stage I, II, III, and IV comprised 62%, 10%, 23%, and 5%, respectively. 75% were endometrioid; 21% serous. Grade 1, 2, and 3 comprised 18%, 22%, and 60%, respectively. Median follow-up was 23.0months. High L1CAM expression was associated with advanced stage (OR 3.2), high grade (OR=6.8), serous histology (OR=16.3), positive cytology (OR=3.5), positive pelvic (OR=21.8) and para-aortic lymph nodes (OR=10.3) (all p≤0.001). High L1CAM was associated with a median overall survival (OS) of 107months, versus not reached for low L1-expressing ECs (HR=3.46, CI 1.97-6.07, p<0.001). On multivariate analysis, L1CAM expression remained an independent prognostic variable in predicting OS in EC.
  
  
  
  L1CAM expression is an independent predictor of poor survival in endometrial cancer, and is associated with advanced stage, high-risk endometrial cancer.
authors: Department of Surgery, Division of Gynecologic Oncology, City of Hope National Medical Center, Duarte, CA, United States. Electronic address: tdellinger@coh.org.
authors: Thanh H
authors: TH
authors: Dellinger
authors: Biostatistics Unit, QIMR Berghofer Medical Research Institute, Royal Brisbane Hospital, Herston, Australia.
authors: David D
authors: DD
authors: Smith
authors: Department of Information Sciences, Beckman Research Institute of City of Hope, Duarte, CA, United States; Department of Molecular Medicine, Beckman Research Institute of City of Hope, Duarte, CA, United States.
authors: Ching
authors: C
authors: Ouyang
authors: Integrative Genomics and Bioinformatics Cores, City of Hope Comprehensive Cancer Center, Duarte, CA, United States.
authors: Charles D
authors: CD
authors: Warden
authors: Department of Molecular Medicine, Beckman Research Institute of City of Hope, Duarte, CA, United States.
authors: John C
authors: JC
authors: Williams
authors: Department of Surgery, Division of Gynecologic Oncology, City of Hope National Medical Center, Duarte, CA, United States.
authors: Ernest S
authors: ES
authors: Han
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000096:biosynthesis / Q000235:genetics; D019002:CD56 Antigen / Q000096:biosynthesis* / Q000235:genetics*; D016889:Endometrial Neoplasms / Q000235:genetics* / Q000378:metabolism* / Q000473:pathology; D005260:Female; D006801:Humans; D008875:Middle Aged; D009367:Neoplasm Staging; D012307:Risk Factors
chemical_list: D014408:Biomarkers, Tumor; D019002:CD56 Antigen; C522918:NCAM1 protein, human
keywords: Endometrial cancer; L1CAM; TCGA