title: L1CAM as a prognostic marker in stage I endometrial cancer: a validation study.
abstract: L1 cell adhesion molecule (L1CAM) overexpression has been reported to be strongly associated with poor prognosis in early stage endometrial cancer (EC). We aimed at the validation of L1CAM as a marker of poor prognosis in an independent study population.
  
  
  
  Patients with endometrioid EC FIGO stage I, were treated at Oslo University Hospital between 2005 and 2012. L1CAM expression was detected by immunohistochemistry with >10 % L1CAM staining defined as positive. Risks of relapse and death were estimated as hazard ratios (HRs) with 95 % confidence intervals (95 % CI).
  
  
  
  Of 450 patients, 388 (86 %) were evaluable for L1CAM expression and 35 (9 %) were L1CAM positive. After follow-up for a median time of 4.8 years (0.1-8.8), 33 (8 %) patients had recurred. 6/35 (17 %) L1CAM positive patients relapsed compared to 27/353 (8 %) L1CAM-negative patients. There were 7 (20 %) deaths in the L1CAM positive group, and 34 (10 %) in the negative group. In multivariate analysis, controlled for age and FIGO stage, L1CAM positivity was not significantly associated with the risk of relapse (HR 2.08, 95 % CI: 0.85-5.10, p = 0.11) or death of all-cause (HR 1.81, 95 % CI: 0.79-4.11, p = 0.16). In patients who were not treated with chemotherapy, L1CAM was significantly associated with risk of relapse (HR 2.9; 95 % CI: 1.08-7.56; p = 0.04).
  
  
  
  Our report confirms that L1CAM is associated with a more aggressive tumortype and more distant relapses. The overall recurrence rate in this population was low as were the absolute differences between L1CAM positive and negative patients. In this independent study sample, L1CAM failed to be a clinically relevant marker of poor prognosis in stage I endometrioid endometrial carcinoma.
authors.affiliation: Department of Gynecologic Oncology, Norwegian Radium Hospital, Oslo University Hospital, PB 4953 Nydalen 0424, Oslo, Norway. esmogeli@mac.com.|Institute of Clinical Medicine, University of Oslo, Faculty of Medicine, Oslo, Norway. esmogeli@mac.com.
authors.forename: Elisabeth
authors.identifier: 0000-0003-3126-1556
authors.initials: E
authors.lastname: Smogeli
authors.affiliation: Department of Pathology, Oslo University Hospital, Norwegian Radium Hospital, Oslo, Norway.|Institute of Clinical Medicine, University of Oslo, Faculty of Medicine, Oslo, Norway.
authors.forename: Ben
authors.initials: B
authors.lastname: Davidson
authors.affiliation: Faculty of Health Sciences, Oslo and Akershus University College of Applied Sciences, Oslo, Norway.
authors.forename: Milada
authors.initials: M
authors.lastname: Cvancarova
authors.affiliation: Department of Pathology, Oslo University Hospital, Norwegian Radium Hospital, Oslo, Norway.
authors.forename: Arild
authors.initials: A
authors.lastname: Holth
authors.affiliation: Institute of Clinical Medicine, University of Oslo, Faculty of Medicine, Oslo, Norway.
authors.forename: Betina
authors.initials: B
authors.lastname: Katz
authors.affiliation: Department of Pathology, Oslo University Hospital, Norwegian Radium Hospital, Oslo, Norway.
authors.forename: Bjørn
authors.initials: B
authors.lastname: Risberg
authors.affiliation: Department of Gynecologic Oncology, Norwegian Radium Hospital, Oslo University Hospital, PB 4953 Nydalen 0424, Oslo, Norway.|Institute of Clinical Medicine, University of Oslo, Faculty of Medicine, Oslo, Norway.|Institute for Cancer Genetics and Informatics, Norwegian Radium Hospital, Oslo University Hospital, Oslo, Norway.
authors.forename: Gunnar
authors.initials: G
authors.lastname: Kristensen
authors.affiliation: Department of Gynecologic Oncology, Norwegian Radium Hospital, Oslo University Hospital, PB 4953 Nydalen 0424, Oslo, Norway.|Department of Medical Oncology, Crown Princess Mary Cancer Care Center, Westmead Hospital, Westmead, NSW, 2145, Australia.|NHMRC Clinical Trials Centre, University of Sydney, Locked Bag 77, Camperdown, NSW, 1450, Australia.
authors.forename: Kristina
authors.initials: K
authors.lastname: Lindemann
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000032:analysis*; D018269:Carcinoma, Endometrioid / Q000401:mortality / Q000473:pathology*; D018572:Disease-Free Survival; D016889:Endometrial Neoplasms / Q000401:mortality / Q000473:pathology*; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D053208:Kaplan-Meier Estimate; D008875:Middle Aged; D039842:Neural Cell Adhesion Molecule L1 / Q000032:analysis / Q000096:biosynthesis*; D011379:Prognosis; D016016:Proportional Hazards Models
chemical_list: D014408:Biomarkers, Tumor; D039842:Neural Cell Adhesion Molecule L1
keywords: Endometrial cancer; L1CAM; Prognostic marker