American Association for Cancer Research
ccr-23-3158_supplementary_figure_s3_suppfs3.pptx (122.47 kB)

Supplementary Figure S3 from Endometrioid Endometrial RNA Index Predicts Recurrence in Stage I Patients

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posted on 2024-07-01, 07:21 authored by Corrine A. Nief, Phoebe M. Hammer, Aihui Wang, Vivek Charu, Amina Tanweer, Babak Litkouhi, Elizabeth Kidd, Andrew J. Gentles, Brooke E. Howitt

Supplemental Figure 3: EERI Values in TCGA Subtypes. A) The Stanford-EEC cohort and subgroups. B) The TCGA-UCEC cohort and subgroups. P-values generated by Whitney-Mann U test. Error bars represent 95% confidence intervals.



Risk prediction with genomic and transcriptomic data has the potential to improve patient outcomes by enabling clinicians to identify patients requiring adjuvant treatment approaches, while sparing low-risk patients from unnecessary interventions. Endometrioid endometrial carcinoma (EEC) is the most common cancer in women in developed countries, and rates of endometrial cancer are increasing. We collected a 105-patient case-control cohort of stage I EEC comprising 45 patients who experienced recurrence less than 6 years after excision, and 60 Fédération Internationale de Gynécologie et d'Obstétrique grade-matched controls without recurrence. We first utilized two RNA-based, previously validated machine learning approaches, namely, EcoTyper and Complexity Index in Sarcoma (CINSARC). We developed Endometrioid Endometrial RNA Index (EERI), which uses RNA expression data from 46 genes to generate a personalized risk score for each patient. EERI was trained on our 105-patient cohort and tested on a publicly available cohort of 263 patients with stage I EEC. EERI was able to predict recurrences with 94% accuracy in the training set and 81% accuracy in the test set. In the test set, patients assigned as EERI high-risk were significantly more likely to experience recurrence (30%) than the EERI low-risk group (1%) with a hazard ratio of 9.9 (95% CI, 4.1–23.8; P < 0.001). Tumors with high-risk genetic features may require additional treatment or closer monitoring and are not readily identified using traditional clinicopathologic and molecular features. EERI performs with high sensitivity and modest specificity, which may benefit from further optimization and validation in larger independent cohorts.