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EPV106/#249 Endometrial cancer immunohistochemical risk stratification in a large uterine-confined cancer series
  1. E Perrone1,
  2. F De Felice2,
  3. I Capasso3,
  4. D Arciuolo4,
  5. E Distefano1,
  6. D Lorusso1,
  7. GF Zannoni4,
  8. G Scambia1 and
  9. F Fanfani1
  1. 1Fondazione Policlinico Universitario A. Gemelli, IRCCS, Uoc Ginecologia Oncologica, Dipartimento Per La Salute Della Donna E Del Bambino E Della Salute Pubblica, Rome, Italy
  2. 2Policlinico Umberto I, ‘Sapienza’ University of Rome, Department of Radiotherapy, Rome, Italy
  3. 3Policlinico universitario Agostino Gemelli, Uoc Ginecologia Oncologica, Roma, Italy
  4. 4Fondazione Policlinico Universitario A. Gemelli, IRCCS, Gyneco-pathology and Breast Pathology Unit, Dipartimento Per La Salute Della Donna E Del Bambino E Della Salute Pubblica, Rome, Italy


Objectives The aim of this study is to assess the clinical reproducibility and the oncological validity of the Endometrial cancer (EC) risk stratification based on the molecular information given by the immunohistochemistry (IHC).

Methods Retrospective IHC analyses were conducted in a large series of 778 pre-operative uterine-confined ECs, studying the presence/absence of MLH1, MSH2, MSH6, to define the mismatch repair (MMR) stable or instable phenotype; the presence of p53 mutations and other molecular features. The molecular profile was correlated with histological, clinical and prognostic EC patients’ data.

Results Based on the IHC, we defined 3 EC populations: MMR stable (MMRs), instable (MMRi) and p53 mutated (p53+) patients. Our result demonstrated that the IHC stratification statistically correlated with the most relevant anatomo-clinical features: FIGO stage (p<0.001), grading (12,5% G3 in MMRs vs 22.9% in MMRi vs 95.3% in p53+, p<0.001), histotype (Type II 6.2% in MMRs vs 5.3% in MMRi vs 87.5% in p53+, p<0.001), presence of LVSI (positive in 16.3% in MMRs vs 23.8% in MMRi vs 38.7% in p53+, p<0.001), myometrial invasion and tumor dimension (p=0.003 and p<0.001 respectively). Again, the 3 IHC populations statistically reflected the EC risk class ESGO-ESMO-ESP classification 2020 (p<0.001). These results were confirmed also in Kaplan-Meier curves in terms of over-all survival (OS) and disease-free survival (DFS) (p<0.001) (figure 1).

Abstract EPV106/#249 Figure 1

Conclusions In this large series, we demonstrated that the pragmatic and systematic use of IHC may have an important role to properly stratify, in terms of histological features and clinical outcome, the uterine-confined EC patients.

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