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  • #671 The impact of molecular classification on recurrence risk in endometrial cancer patients with lymph node metastasis: a multicenter retrospective study

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Poster/ePoster Sessions
03. Endometrial cancer
#671 The impact of molecular classification on recurrence risk in endometrial cancer patients with lymph node metastasis: a multicenter retrospective study
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  1. Gabriella Schivardi1,2,
  2. Luigi Antonio De Vitis1,2,
  3. Giuseppe Cucinella1,
  4. Francesco Multinu1,2,
  5. Vanna Zanagnolo2,
  6. Ilaria Betella2,
  7. Glauco Baiocchi3,
  8. Louise De Brot3,
  9. Tommaso Occhiali4,1,
  10. Giuseppe Vizzielli4,
  11. Robert Giuntoli5,
  12. Angela Fought6,
  13. Michaela Mcgree6,
  14. Maryam Shahi7,
  15. Andrea Mariani1 and
  16. Gretchen Glaser1
  1. 1Department of Obstetrics and Gynecology, Mayo Clinic, Rochester, Mn, USA
  2. 2Division of Gynecological Surgery, European Institute of Oncology, Milan, Italy
  3. 3A.C. Camargo Cancer Center, Sao Paulo, Brazil
  4. 4Clinic of Obstetrics and Gynecology, Azienda sanitaria universitaria Friuli Centrale, Udine, Italy
  5. 5Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, University of Pennsylvania Health System, Philadelphia, Pa, USA
  6. 6Division of Clinical Trials and Biostatistics, Mayo Clinic, Rochester, Mn, USA
  7. 7Department of Pathology, Mayo Clinic, Rochester, Mn, USA

Abstract

Introduction/Background The impact of molecular classes on the risk of recurrence in node-positive endometrial cancer (EC) is still unclear. This study aims to evaluate the distribution of molecular classes and their impact on the risk of recurrence in FIGO stage IIIC EC.

Methodology EC patients with FIGO stage IIIC (including micrometastasis and macrometastasis) who underwent surgical staging from October 2013 to September 2022 and had subsequent molecular characterization were identified among five referral centers worldwide. The molecular analysis included immunohistochemistry for p53 and MMR proteins and sequencing for POLE exonuclease domain. ECs were classified into four molecular classes (POLEmut, MMRd, p53abn, and NSMP). Survival analyses were performed using Kaplan-Meier and Cox models (univariate and multivariable) to evaluate the relationship between molecular classes and recurrence within 5 years after surgery.

Abstract #671 Figure 1
Abstract #671 Figure 1

A: Comparison of clinicopathological characteristics by molecular class. B. Molecular classes distribution. C. Recurrence-free survival analysis by molecular class.

Results A total of 134 patients were included; 57(42.5%) tumors were NSMP, 44(32.8%) MMRd, 1(0.7%) POLEmut, and 32(23.9%) p53abn (figure 1). Overall, 52 (38.8%) patients experienced a recurrence within the first 5 years following surgery with a median time of 1.2 years (IQR 0.5–1.7), including 17(32.7%), 14(26.9%), and 21(40.4%) among NSMP, MMRd, and p53abn cases respectively. No recurrence was observed in the POLEmut case. Survival analysis revealed a significant difference in RFS between NSMP, MMRd and p53abn classes(log-rank p<0.01) (figure 1). Similarly, in univariate analysis the molecular class was a significant predictor of recurrence (p<0.01). In multivariable analysis, adjusting for grade and type of lymph node metastasis, p53abn EC showed twice the risk of recurrence compared to NSMP (HR 2.12, CI 1.04–4.29).

Conclusion Our findings indicate a high prevalence of p53abn tumors among patients with stage IIIC EC. Moreover, our study highlighted the significant impact of molecular classification on the risk of recurrence in these patients. Further studies are needed to better understand the impact of molecular classes compared to pathological features.

Disclosures The authors have nothing to disclose.

https://doi.org/10.1136/ijgc-2023-ESGO.362

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