Relationship between molecular markers and lymphadenectomy and lymphovascular space invasion in endometrial cancer

• Published in: Archives of gynecology and obstetrics Vol. 308; no. 3; pp. 941 - 946
• Main Authors: Bilir, Filiz, Arıoz, Dagıstan Tolga, Arıkan, Suna Evrim, Yalcın, Gulsum Seyma, Ozdemir, Cigdem, Demir, Hacer, Chkhikvadze, Mariam, Ozdemir, Cem Yagmur, Cicekli, Nayif, Vatansever, Nefize, Yılmaz, Sezgin
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01-09-2023; Springer Nature B.V
• Subjects: Endocrinology; Endometrial cancer; Endometrial Neoplasms - genetics; Endometrial Neoplasms - pathology; Endometrial Neoplasms - surgery; Female; Gynecologic Oncology; Gynecology; Human Genetics; Humans; Lymph Node Excision; Lymph Nodes - pathology; Lymph Nodes - surgery; Lymphatic Metastasis - pathology; Lymphatic system; Medicine; Medicine & Public Health; Metastasis; Neoplasm Staging; Obstetrics/Perinatology/Midwifery; Retrospective Studies; Uterine cancer; Lymph node metastasis; Lymphovascular space invasion; Endometrial cancer; Molecular subgroups
• ISSN: 1432-0711; 0932-0067; 1432-0711
• DOI: 10.1007/s00404-023-07005-9

Purpose
Relationship between pathologic parameters, surgical parameters, or lymph node status with oncologic outcomes is not fully elucidated in endometrial cancer (EC). We want to investigate the molecular classification of uterine cancer in the Turkish population and its relationship between lymphadenectomy and lymph node metastasis.
Methods
In this study, 100 patients' clinical and pathologic data diagnosed with EC were analyzed. Pathologic and molecular parameters were investigated and compared them with clinical parameters.
Results
According to the molecular analysis, 16 patients (16%) had p53 mutation, 3 patients (3%) were classified as POLE mutant group, 38 (38%) patients in the MSI group, and the remaining 43 patients (43%) into the no specific mutation profile (NSMP) group. Lymph node metastasis rate was significantly higher in copy number high (CNH) group compared to the others. In the CNH group, 29 of 437 (6.6%) dissected lymph nodes had metastasis. The median OS was the highest in the POLE group (72 months) and lowest in the CNH group (36 months).
Conclusion
Endometrial cancer patients showed significantly different overall and disease-free survival according to the molecular subtypes and it was consistent with the literature, Lymph node metastasis risk was the highest in CNH group. MSI status is important for the lymph node metastasis risk but not all abnormalities, especially PMS2 and MLH1 expression changes showed the highest risk.