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  • #598 Improving endometrial cancer assessment by combining the new technique of genomic profiling with surgical extra uterine disease assessment (EUGENIE). Results after one year of enrolment

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03. Endometrial Cancer
#598 Improving endometrial cancer assessment by combining the new technique of genomic profiling with surgical extra uterine disease assessment (EUGENIE). Results after one year of enrolment
  1. Luigi Congedo1,2,
  2. Rita Trozzi1,2,
  3. Emanuele Perrone1,
  4. Camilla Nero1,2,
  5. Emilia Palmieri1,2,
  6. Aniello Foresta1,2,
  7. Luca Palmieri1,2,
  8. Thaïs Baert3,
  9. Annouschka Laenen4,
  10. Anne-Sophie Van Rompuy5,6,
  11. Giuseppe Vizzielli7,8,
  12. Jure Knez9,
  13. Giovanni Scambia1,2,
  14. Francesco Fanfani1,2 and
  15. Frédéric Amant3,10
  1. 1Department of Women, Children and Public Health Sciences, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
  2. 2Facolta` di Medicina e Chirurgia, Universita` Cattolica del Sacro Cuore, Rome, Italy
  3. 3Division of Gynecologic Oncology; Department of Obstetrics and Gynecology, KU Leuven University Hospitals Leuven, Leuven, Belgium
  4. 4Leuven Biostatistics and Statistical Bioinformatics Centre (L-BioStat), KULeuven, Leuven, Belgium
  5. 5Department of Pathology, University Hospitals Leuven, Leuven, Belgium
  6. 6Laboratory of Translational Cell and Tissue Research, Department of Imaging and Pathology, KU Leuven – University of Leuven, Leuven, Belgium
  7. 7Department of Medicine, University of Udine, Udine, Italy
  8. 8Clinic of Obstetrics and Gynecology,, Udine, Italy
  9. 9Department for Gynaecological Oncology, University Medical Centre Maribor, Maribor, Slovenia
  10. 10Center for Gynaecologic Oncology, Netherlands Cancer Institute, Amsterdam, The Netherlands

Abstract

Introduction/Background The new molecular classification of endometrial cancer (EC) has been shown to improve prognosis prediction and it has recently been incorporated in the 2023 FIGO staging. However, the exact risk and type of metastases at the time of diagnosis and their prognostic value in each molecular subgroup are currently unknown.

Methodology EUGENIE is an ongoing prospective multicentre study, aiming to improve the traditional surgery-based staging by the use of molecular classification. 1000 EC patients will receive a complete surgical staging, consisting of sentinel-node procedure and/or pelvic and para-aortic lymph-node dissection, as well as peritoneal and omental biopsy or omentectomy. The staging information will be matched with the molecular features to determine whether each molecular subgroup is associated with a specific pattern of extra-uterine disease.

Results At the data cut-off of 15/01/2024 complete histological and molecular data are available for 280 patients. Among them, 72 (25,7%) were in advanced stages (2009 FIGO stage III or IV), with the highest incidence in the p53-aberrant group (p53abn- 46.5%). Remarkably, 5 patients were upstaged because of unexpected positive study-specific omental and/or peritoneal biopsies (1 Non-specified molecular profile -NSMP, 1 mismatch repair deficiency - MMRd, 3 p53abn). Lymph nodal metastases were detected in all 4 molecular subgroups, even though only one POLE patients (4.5%) had positive pelvic lymph nodes. Transperitoneal and systemic spread was observed in MMRd, p53abn, and NSMP EC, with the highest incidence in the p53abn group, reaching the 20.9% of peritoneal spread.

Conclusion After enrolling more than 25% of patients, we detected 1.8% of unexpected peritoneal metastases. p53abn seems to be associated with the highest rate of peritoneal metastases, while positive lymph nodes have been detected mostly in p53abn and MMRd patients. A very low percentage of lymph nodal metastases has been detected in POLE cases.

Disclosures The authors declare no disclosures.

View this table:
Abstract #598 Table 1

Association of each molecular subgroup with early or advanced disease stage and with the spread of the disease to the extra-uterine sites. For each case, all the involved extra-uterine sites are annotated. NSMP: Non-specified molecular profile; MMRd: mismatch repair deficiency; P53abn: p53 aberrant; POLE: POLE mutated.

https://doi.org/10.1136/ijgc-2024-ESGO.1116

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