You are here

  • Home
  • Archive
  • Volume 32, Issue Suppl 2
  • 2022-RA-987-ESGO Molecular characterization of endometrial cancer with low volume metastasis in the sentinel lymph node: a multicentric international study

Article Text

Article menu

Download PDFPDF

Endometrial cancer
2022-RA-987-ESGO Molecular characterization of endometrial cancer with low volume metastasis in the sentinel lymph node: a multicentric international study
Free
  1. Gabriella Schivardi1,2,
  2. Giuseppe Cucinella1,3,
  3. Andrea Mariani1,
  4. Maryam Shahi4,
  5. Carrie Langstraat1,
  6. Amy Weaver5,
  7. Michaela Mc Gree5,
  8. Francesco Multinu2,
  9. Vanna Zanagnolo2,
  10. Ilaria Betella2,
  11. Glauco Baiocchi6,
  12. Louise de Brot6,
  13. Robert Giuntoli7,
  14. Spyridon Mastroyannis7 and
  15. Gretchen Glaser1
  1. 1Department of Obstetrics and Gynecology, Division of Gynecologic Surgery, Mayo clinic, Rochester, MN
  2. 2Department of Gynecology, European Institute of Oncology, IEO, IRCCS, Milan, Italy
  3. 3Department of Gynecologic Oncology, University of Palermo, Palermo, Italy
  4. 4Department of Pathology, Mayo clinic, Rochester, MN
  5. 5Department of Quantitative Health Sciences, Mayo clinic, Rochester, MN
  6. 6Department of Gynecologic Oncology, A.C. Camargo Cancer Center, Sao Paulo, Brazil
  7. 7Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, University of Pennsylvania Health System, Philadelphia, PA

Abstract

Introduction/Background The primary aims of this study were to assess the molecular characterization of endometrial cancer (EC) patients with low volume metastasis (LVM) in the sentinel lymph node (SLN) and to identify the molecular predictors of recurrence among those patients.

Methodology Patients with EC and LVM [isolated tumour cells (<0.2 mm) – micrometastasis (≥ 0.2 < 2 mm)] who underwent surgery from August 2014 to November 2020 and had subsequent molecular characterization were identified among four referral centres worldwide. Patients with adnexal involvement and FIGO stage IV were excluded. The molecular analysis included immunohistochemistry for p53 and MMR proteins and Sanger sequencing for POLE exonuclease domain. ECs were classified into four molecular classes (POLEmut, MMRd, p53abn, and NSMP).

Results Among 101 patients, the molecular classification showed 56 NSMP, 31 MMRd, 13 p53Abn, and 1 POLEmut. Of 12 non-endometrioid cases, 11 were p53abn. Overall, 15 patients experienced a recurrence, and the median follow-up for the remaining patients was 3.1 (IQR, 2.0–3.8) years. The 3-year RFS was 90.4% (95% CI 95%, 81.8–99.9%), 82.1% (95% CI, 69.0–97.8%) and 65.6% (95% CI, 43.2%-99.7%), for the NSMP, MMRd, and p53Abn classes, respectively. No recurrence was observed in the POLEmut case. The overall RFS analysis between the three classes was comparable (p=0.11), and the comparison between p53abn class and the other classes did not reach a significant difference (p=0.07).

On univariate analysis, the presence of micrometastasis (p=0.02), non-endometrioid histology (p=0.02), lymphovascular space invasion (p=0.04), and positive peritoneal cytology (p=0.005) were significant predictors of recurrence.

Abstract 2022-RA-987-ESGO Figure 1
Abstract 2022-RA-987-ESGO Figure 1

(A) Recurrence-free survival according to molecular classes (NSMP, MMRd, p53abn). (B) Recurrence-free survival according to p53 status (p53abn vs. All other classes)

Conclusion Among EC patients SLN-LVM, there is a low rate of POLEmut tumours. Our results confirmed that traditional pathological features have a strong impact on prognosis among SLN-LVM patients. We did not observe significant impact of the molecular classes on the risk of recurrence, however further studies are needed.

https://doi.org/10.1136/ijgc-2022-ESGO.268

Statistics from Altmetric.com

    Request Permissions

    If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.