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823 Improving preoperative binary grading: relevance of P53 and PR expression in grade 2 EEC
  1. Puk Meijs-Hermanns1,
  2. Henrica MJ Werner1,2,
  3. Loes Kooreman1,2,
  4. Petra Vinklerová3,
  5. Stephanie Vrede4,
  6. Jasmin Asberger5,
  7. Markéta Bednaríková6,
  8. Dorry Boll7,
  9. Antonio Gil-Moreno8,
  10. Jitka Hausnerová9,
  11. Jutta Huvila10,
  12. Martin Koskas11,
  13. Camilla Krakstad12,13,
  14. Heidi Küsters-Vandevelde14,
  15. Gemma Mancebo Moreno15,
  16. Maria Santacana16,
  17. Koen Van De Vijver17,
  18. Dennis Van Hamont18,
  19. Johanna MA Pijnenborg4 and
  20. Nicole CM Visser19
  1. 1Maastricht University Medical Centre, Maastricht, The Netherlands
  2. 2GROW-School for Oncology and Reproduction, Maastricht, The Netherlands
  3. 3University Hospital Brno, Brno, Czech Republic
  4. 4Radboud University Medical Centre, Nijmegen, The Netherlands
  5. 5Medical Centre - University of Freiburg, Freiburg, Germany
  6. 6University Hospital and Masaryk University, Brno, Czech Republic
  7. 7Catharina Hospital, Eindhoven, The Netherlands
  8. 8Vall d'Hebron University Hospital, Barcelona, Spain
  9. 9University Hospital Brno and Masaryk University, Brno, Czech Republic
  10. 10University of Turku, Turku, Finland
  11. 11APHP-Bichat Hospital, Paris, France
  12. 12University of Bergen, Bergen, Norway
  13. 13Haukeland University Hospital, Bergen, Norway
  14. 14Canisius-Wilhelmina Hospital, Nijmegen, The Netherlands
  15. 15Hospital del Mar, Barcelona, Spain
  16. 16Lleida Institute for Biomedical Research Dr. Pifarré Foundation, IRBLleida, Hospital Universitari Arnau de Vilanova, Lleida, Spain
  17. 17Ghent University Hospital, Ghent, Belgium
  18. 18Amphia Hospital, Breda, The Netherlands
  19. 19Eurofins PAMM, Eindhoven, The Netherlands


Introduction/Background Recent guidelines propose a binary grading for endometrial cancer (EC) in low- or high grade, in which all endometrioid EC (EEC) grade 1 and 2 are considered low-grade and treated accordingly. However, pre- and postoperative agreement was the lowest in grade 2 with clinically relevant upgrading in 14% in a previously published study. This presents a potential risk of undertreatment within this group. A dual immunohistochemical staining approach with progesteron receptor (PR) and p53 has been demonstrated to be helpful in improving pre- and postoperative concordance in grade 2 EECs. The aim of this study was to evaluate the impact of preoperative PR and p53 expression on prognosis in grade 2 EEC.

Methodology Three European EC study cohorts were merged. Preoperative non-EECs and grade 2 EECs without preoperative p53 or PR status were excluded from analysis. A total of 1150 patients were included, incorporating 400 patients with grade 2 EECs. Kaplan Meier and Cox-regression analyses were performed.

Results Patients with preoperative grade 2 EEC and p53 wild-type plus PR positive expression showed a similar survival to patients with grade 1 EEC, while survival of patients with aberrant p53 and/or negative PR expression was more comparable to grade 3 EECs (Figure 1). The combination of these markers was an independent prognostic factor in multivariate regression analyses.

Conclusion The prognostic impact of preoperative p53 and PR expression in patients with grade 2 EEC supports a modified binary grading system, in which grade 2 EECs should be preoperatively classified as low- or high-grade depending on p53 and PR expression.

Disclosures No disclosures.

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