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Endometrial cancer
2022-RA-1569-ESGO Molecular profile in endometrial carcinoma: can we predict the lymph node status?
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  1. Ana Luzarraga,
  2. Natalia Rodriguez Gomez-Hidalgo,
  3. Silvia Cabrera,
  4. Vicente Bebia Conesa,
  5. Asuncion Perez-Benavente and
  6. Antonio Gil Moreno
  1. Gynecologic Oncology, Hospital Vall d’Hebron, Barcelona, Spain

Abstract

Introduction/Background The lymph node status (LNS) according to molecular classification (MC) in endometrial cancer is heterogenous and underreported. Thus, the role of MC to tailor pre-operatively surgical treatment remains unclear. We aimed to analyze LN metastasis (LNM) and histopathological features of the four MC groups.

Methodology Original articles including LN status according to MC with Leuven algorithm following the recommendations of ESGO-ESTRO-ESP guidelines were included in this systematic review and meta-analysis. Articles reporting MC following ProMise algorithm were excluded, except those in which information about tumors encompassing more than one mutation was available. Number of cases were extracted to calculate proportion and their 95%CI. Summary proportion estimates were obtained using Dersimonian-Lair random-effects meta-analysis. Statistical heterogeneity was assessed through Cochran’s Q-test and I2 statistic.

Results 5122 records were identified by combining ‘EC’, ‘MC’, ‘TCGA’, ‘p53’, ‘POLE’, ‘MSI’, ‘NSMP’. 16 studies with 4294 patients were included (figure 1): 260 (6.9%) POLE-mutated, 831 (31.9%) MSI, 795 (25.2%) p53-abnormal and 1127 (35.7%) non-specific-molecular-profile (NSMP). LN involvement was present in 6% of POLE-mut (I2=0%), 15% of MSI (I2=87%), 26% of p53-abnormal (I2=82.9%), and 9% of NSMP (I2=76.2%). Five articles reported 0% of LNM in POLE-mutated and had been excluded of the pooled-prevalence-calculation due to statistic incongruency. Grade3 tumors were found in 42% of POLE-mut (I2=80.6%), 32% of MSI (I2=95.6%), 66% of P53-abnormal (I2=99.4%), and 11% of NSMP (I2=80.1%). Lymphovascular-invasion was present in 33% of POLE-mutated (I2=84.2%), 40% of MSI (I2=89.7%), 48% of p53-abnormal (I2=91%), and 27% of NSMP (I2=94%). Deep myometrial invasion was present in 31% (I2=0%) of POLE-mutated, 32% of MSI (I2=77.4%), 37% of p53-abnormal (I2=93.7%), and 27% of NSMP (I2=93.2%).

Abstract 2022-RA-1569-ESGO Figure 1
Abstract 2022-RA-1569-ESGO Figure 1
Abstract 2022-RA-1569-ESGO Figure 2
Abstract 2022-RA-1569-ESGO Figure 2

Conclusion P53-abnormal presented the highest LNM rate, followed by MSI tumors, in contrast to POLE-mutated and NSMP cohort.

https://doi.org/10.1136/ijgc-2022-ESGO.343

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