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75 The association of molecular changes with oncological results on low and intermediate risk endometrial cancers and the effect of new risk groups created by combining histopathologİcal data and molecular changes on clinical management
  1. Elif Aksahin1,
  2. Fuat Demirkiran1,
  3. Tugan Bese1,
  4. Sennur Ilvan2,
  5. Abdullah Serdar Acikgöz1,
  6. Ismail Yilmaz3,
  7. Ayse Hanim Yavuz2,
  8. Ilker Kahramanoglu1,
  9. Hasan Turan1,
  10. Basak Ozge Kayan1,
  11. Sait Sukru Cebi1,
  12. Yeliz Aykanat1 and
  13. Macit Arvas1
  1. 1Istanbul University – Cerrahpasa, Cerrahpasa Medical Faculty, Department of Gynecology and Obstetrics, Divison of Gynecologic Oncology, Istanbul, Turkey
  2. 2Istanbul University-Cerrahpasa, Cerrahpasa Medical Faculty, Department of Pathology, Istanbul, Turkey
  3. 3Saglik Bilimleri University Sultan 2. Abdulhamid Han Hospital, Department of Pathology, Istanbul, Turkey


Introduction/Background This study’s objectives include identifying various molecular subgroups in endometrioid-type endometrial cancers (EEC), investigating the association between molecular profile and clinicohistopathological data and determining low and intermediate risk EC groups by merging the data collected.

Methodology Retroprospective analysis was performed on 1040 individuals who underwent surgery and were monitored between January 2000 and June 2022. Out of 900 EEC cases, 72 had recurrence. Matching was done between the patient groups with tumor recurrence (n=62) and those without (n=52). The 9th, 13th, and 14th exons of the POLE gene were examined with Sanger sequencing to determine the mutation status in the tumor tissue blocks, as well as P53, MMR proteins (PMS2, MSH1, MSH2, MSH6), CTNNB1 and L1CAM antibodies by immunohistochemical staining methods.

Results POLE-mut%7, MMR-d%48, p5mut 10,5%, and NSMP 42% were identified among the cases. POLE and P53 mutations were found more frequently in high grade tumors (p<0.05), It was more common for MMR-d tumors to be >4 cm, LVSI positive, and MI >50% (p<0.005). In POLE-mut tumors, no recurrence was observed (p:0,001). MMR-d was found to be significantly associated with tumor recurrences (p:0,015). MMR-d, p53mut, and NSMP had median DFS of 24, 49, and 85 months, respectively, while p53, MMR-d, and NSMP had median OS of 102,128 and 181 months. A significant correlation between molecular profile and DFS was found using Kaplan-Meier analysis (p:0,004). In the Multivariate-Cox analysis, it was determined that p53 mutation, high grade, and LVSI positivity decreased OS while NSMP significantly increased DFS.

Conclusion Stage 1–2 POLEmut cases should be included in the low risk group regardless of LVSI status. On the other hand, instances with LVSI-detected p53-mutation in stage Ib-II and grade III cases could be classified as high risk, whereas those without LVSI could be classified as medium-high risk.

Disclosures The authors have nothing to disclose.

Abstract 75 Table 1

Cox regression analysis of independent variables in terms of overall survival (OS).

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