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Objective: Pre-operative immunohistochemical (IHC) biomarkers are not incorporated in endometrial cancer (EC) risk classification. We aim to investigate the added prognostic relevance of IHC biomarkers to the ESMO-ESGO-ESTRO risk classification and lymph node (LN) status in EC., Methods: Retrospective multicenter study within the European Network for Individualized Treatment of Endometrial Cancer (ENITEC), analyzing pre-operative IHC expression of p53, L1 cell-adhesion molecule (L1CAM), estrogen receptor (ER) and progesterone receptor (PR), and relate to ESMO-ESGO-ESTRO risk groups, LN status and outcome., Results: A total of 763 EC patients were included with a median follow-up of 5.5-years. Abnormal IHC expression was present for p53 in 112 (14.7%), L1CAM in 79 (10.4%), ER- in 76 (10.0%), and PR- in 138 (18.1%) patients. Abnormal expression of p53/L1CAM/ER/PR was significantly related with higher risk classification groups, and combined associated with the worst outcome within the 'high and advanced/metastatic' risk group. In multivariate analysis p53-abn, ER/PR- and ESMO-ESGO-ESTRO 'high and advanced/metastatic' were independently associated with reduced disease-specific survival (DSS). Patients with abnormal IHC expression and lymph node metastasis (LNM) had the worst outcome. Patients with LNM and normal IHC expression had comparable outcome with patients without LNM and abnormal IHC expression., Conclusion: The use of pre-operative IHC biomarkers has important prognostic relevance in addition to the ESMO-ESGO-ESTRO risk classification and in addition to LN status. For daily clinical practice, p53/L1CAM/ER/PR expression could serve as indicator for surgical staging and refine selective adjuvant treatment by incorporation into the ESMO-ESGO-ESTRO risk classification., Competing Interests: Declaration of Competing Interest The authors have declared no conflicts of interest., (Copyright © 2021 The Authors. Published by Elsevier Inc. All rights reserved.)

Aim: Understanding how species assemble into assemblages and identifying the determinants of assembly processes remains a key challenge in ecology. Within assemblages, functional trait dispersion can be used to infer assembly processes, but this inference could depend on the trait considered. Here, using both single and multiple trait‐based approaches, we analysed dispersion patterns for alpha (i.e., related to niche partitioning) and beta (i.e., related to environmental tolerance) traits in freshwater fish assemblages and characterized how trait dispersion patterns vary along environmental gradients at large spatial scale. Location: Western Palaearctic, 290 river catchments. Time period: Contemporary. Major taxa studied: Freshwater fish. Methods: Based on freshwater fish occurrence records in 290 European river catchments, we computed dispersion indices (mean pairwise distance) using standardized effect sizes for each single trait and multiple traits. We then used linear models including climatic, geo‐morphological, biotic and human‐related factors to determine the key drivers shaping freshwater fish dispersion patterns across Europe. Results: We highlighted spatial variation in trait dispersion, with both underdispersion and overdispersion simultaneously observed for a given trait, but also distinct patterns of trait dispersion, even within beta and alpha traits. We provided evidence that elevation range and current and past climatic conditions mainly structured trait dispersion patterns. Finally, our results revealed that spatial patterns in trait dispersion based on multiple traits were less pronounced than those based on individual traits. Main conclusions: Our results highlighted that traits showed different spatial and environmental patterns, reflecting different ecological patterns. This could lead to potential problems when using functional indices computed on multiple traits and challenges their relevance to describe diversity patterns and to infer the assembly processes shaping community structure. [ABSTRACT FROM AUTHOR]

Endometrial cancer is the most common gynecologic malignancy in Europe and usually diagnosed in its initial stage owing to early symptoms of abnormal bleeding. There is no population screening for this disease, although it can sometimes be accidentally diagnosed in asymptomatic patients. Our study aims to determine differences in clinical and tumor characteristics between an asymptomatic and symptomatic group of patients. This unicentric prospective observational study took place in University Hospital Brno between January 2016 and December 2019. A total of 264 patients met inclusion criteria (26% asymptomatic, 74% with reported symptoms). We did not find a statistically significant difference in clinical characteristics (menopausal status, parity, age, BMI, and serum level of CA 125) between groups. According to ultrasound examination, bleeding tumors were larger (19.5 vs. 12.7 mm, p ≤ 0.001). Definitive histology results indicated more frequent lymphovascular space invasion (p < 0.001), along with deep myometrial (p = 0.001) and cervical (p = 0.002) invasion. There was no difference in advanced stages of the tumor. We did not substantiate statistically significant difference in immunohistochemical profile (estrogen and progesterone receptors, L1 cell adhesion molecule, tumor protein p53), which is relevant for tumor recurrence risk and survival capacity. Our conclusions affirmed that bleeding occurs more often among patients with local tumor invasion into the myometrium and cervical stroma. Final International Federation of Gynecology and Obstetrics (FIGO) stage, histology, and immunohistochemical characteristics do not significantly affect symptom appearance. [ABSTRACT FROM AUTHOR]