# Determining the clinical significance of intraluminal tumor cells in endometrial cancer

> **NIH NIH R03** · OHIO STATE UNIVERSITY · 2020 · $78,000

## Abstract

PROJECT SUMMARY/ABSTRACT
Mortality from endometrial cancer, the most common gynecologic malignancy in the United States, increased
by 2% per year between 2010 and 2014, one of the few cancers to demonstrate rising mortality rates. The
most powerful prognostic factor affecting endometrial cancer mortality is stage, which details the extent to
which the primary tumor has spread beyond the uterus. Over time, staging criteria have evolved as new clinical
data have emerged; however, one potentially important mode of spread not incorporated in endometrial cancer
stage criteria is transtubal spread, which occurs when endometrial cancer cells are exfoliated through the
fallopian tubes into the abdominal cavity. Despite the recognition that endometrial cancer cells have the
capacity for cellular detachment and transtubal transportation, and that this mechanism co-occurs with other
aggressive tumor characteristics, we lack empirical data on the prognostic impact of transtubal spread and
whether this relationship is modified by other tumor characteristics. The overarching goals of the proposed
study are to determine precise estimates of the relationship between intraluminal tumor cells (ILTCs) — an
objective measure of transtubal spread — and clinical outcomes, and to assess whether incorporation of this
tumor feature improves predictive accuracy. To achieve our goals, we will pool resources from five large
academic hospitals. We will collect digital images of archived fallopian tube slides and conduct a pathology
review to determine ILTC presence in 1,429 endometrial cancer patients. This information will be merged with
existing clinical data to determine the relationship between ILTCs and survival outcomes according to
histological subtype and stage (Aim 1). We will also examine whether the addition of ILTCs improves prognostic
accuracy (Aim 2). Results from our published pilot data lead us to expect that ILTC presence will be associated
with survival, particularly among women diagnosed with serous tumors or stage I tumors. Moreover, we expect
to observe greater accuracy in prediction of survival outcomes once stage has been revised to incorporate
ILTC status. This investigation will be the first well-powered analysis of the impact of transtubal spread on
endometrial cancer prognosis. Our results have high translational potential for refining stage criteria and
improving risk stratification, in order to better guide post-operative treatment decisions and reduce endometrial
cancer mortality.

## Key facts

- **NIH application ID:** 10005231
- **Project number:** 5R03CA230673-02
- **Recipient organization:** OHIO STATE UNIVERSITY
- **Principal Investigator:** Ashley S. Felix
- **Activity code:** R03 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $78,000
- **Award type:** 5
- **Project period:** 2019-09-01 → 2022-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10005231

## Citation

> US National Institutes of Health, RePORTER application 10005231, Determining the clinical significance of intraluminal tumor cells in endometrial cancer (5R03CA230673-02). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10005231. Licensed CC0.

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