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Endometrial cancer
2022-RA-585-ESGO Come back to the future: the impact of estrogen receptor profile in the era of molecular endometrial cancer classification
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  1. Emanuele Perrone1,
  2. Ilaria Capasso2,
  3. Francesca de Felice3,
  4. Giorgia Dinoi1,
  5. Niccolo Bizzarri1,
  6. Aniello Foresta4,
  7. Domenica Lorusso1,
  8. Giovanni Scambia1 and
  9. Francesco Fanfani1
  1. 1Gynecologic Oncology Unit, Dipartimento per le Scienze della Salute della Donna del Bambino e di San, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
  2. 2Dipartimento per le Scienze della Salute della Donna del Bambino e di Sanità Pubblica, Università Cattolica del Sacro Cuore, Rome, Italy
  3. 3Policlinico Umberto I, Rome, Italy
  4. 4Università Cattolica del Sacro Cuore, Rome, Italy

Abstract

Introduction/Background The estrogens receptor (ER) expression in endometrial cancer (EC) is known to be associated with prognosis. However, its role was not included in the latest molecular risk classification system. The aim of this study is to assess the impact of ER profile on oncological outcomes in the new EC risk classification.

Methodology Retrospective IHC analyses were conducted in a large series of ECs, studying the presence/absence of hormone receptors and other molecular (i.e p53 and mismatch mutational status), histopatological and clinical outcome. The ER status was correlated with molecular, histological, clinical and prognostic data.

Abstract 2022-RA-585-ESGO Figure 1
Abstract 2022-RA-585-ESGO Figure 1

Results 891 EC-patients were included in the study (211 ER-negative and 680 ER-positive). The ER-negative phenotype was linked with an unfavorable pathologic-clinical profile (grading, histotype, LVSI, stages, etc) and with high and advanced risk class (64.5vs 27%) (p<0.05). Molecular analysis in ER-negative compared to ER-positive showed greater p53-mutation rate (39% vs 10%), similar MMR-deficiency (20% vs 23.5%), fewer MMR-stability (38% vs 65%) (table1). Noteworthy, simple regression demonstrated that ER-negativity was related to worse OS and DFS, regardless of p53 status; whereas for ER-positive, the prognosis was strongly associated to molecular status (p<0.05). When associated to risk classes, ER-negative EC patients had the worst outcomes compared to the ER-positive counterparts, especially for intermediate, high-intermediate and high-risk classes (p<0.05) (figure1).

View this table:
Abstract 2022-RA-585-ESGO Table 1

Conclusion We demonstrated that the ER status has a significant impact on oncological outcomes, regardless of risk class and p53/MMR status. On these bases, we advise to include ER assessment in featured EC risk classification system.

https://doi.org/10.1136/ijgc-2022-ESGO.217

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