Introduction/Background Staging operations for early stage endometrial cancer are performed uniformly, despite the fact that pathologic information can be obtained prior to surgery. According to molecular categories identified in the Cancer Genome Atlas, p53 mutation and MMRd are associated with poor prognosis. If there is a correlation between the molecular profile obtained from endometrial biopsy tissue and the extent of disease after surgery, it may be possible to personalize surgical planning.
Methodology This study compared the p53 and MMR status of 173 patients with newly diagnosed and clinically staged I-II endometrial cancer who underwent surgical staging, with their final pathological results. All were classified into three groups based on their molecular profiles: abnormal p53, MMRd, and NSMP (no specific molecular profile). We analyzed the involvement status of cervix, adnexa, and lymph nodes and 2-year progression-free survival using Kruskal-Wallis test and log rank test, Cox proportional hazard model.
Results Out of 173 patients, 17(9.8%) were assigned to p53 abnormal group, 33(19.1%) to MMRd group, and 123(71.1%) to NSMP group. Among them, 18(10.4%) had cervical involvement (p=0.115), 8(4.6%) had adnexal involvement (p=0.328), and 8(4.6%) had lymph node involvement (p=0.860) indicating no statistically significant relationship between molecular profile and disease extent. Two patients in the NSMP group expired. 3 in MMRd group, 1 in p53 abnormal group, and 6 in NSMP group experienced recurrence. There was no statistically significant difference in progression-free survival rates among the groups (p=0.6). and hazard ratios between the MMRd group and each of the other groups.
Conclusion Molecular profiles do not seem to determine the prognosis based on the difference in stage at first onset in early stage endometrial cancer. Staging operations should follow current guidelines, but It is necessary to make efforts to individualize treatment plans based on information obtained through preoperative histology.
Disclosures There are no financial conflicts of interest to disclose.
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