EP186/#742 Is it time to test all endometrial carcinomas for P53 mutation?. (4th December 2022)

• Record Type: Journal Article
• Authors: Fard, Elmira Vaziri; Imboden, Sara; Rau, Tilman; Epstein, Elisabeth; Petta, Tirzah; Walia, Saloni; Carlson, Joseph
• Is Part Of: International journal of gynecological cancer. Volume 32(2022)Supplement 3
• Page Start: A123
• Page End: A124
• Publication Date: 2022-12-04
• Subjects: Generative organs, Female -- Cancer -- Periodicals; 616.99465
• DOI: 10.1136/ijgc-2022-igcs.277
• Languages: English
• ISSNs: 1048-891X

Abstract

Abstract : Objectives: Historically, p53 mutation has been considered a diagnostic marker for serous endometrial carcinoma. Of the recently adopted molecular subtypes, p53 abnormal (copy number high) is the most aggressive. The aim of this study was to explore the histologic and clinical characteristics of p53 abnormal endometrial carcinoma regardless of their histologic subtype or grade. Methods: A total of 146 p53 mutated endometrial carcinoma cases were included (44 cases from the Karolinska Institute, 37 cases from Bern University Hospital and 65 cases from the TCGA database). Based on availability, 1–2 representative digital slides from each case were reviewed. Morphologic, molecular, clinical and follow up data were recorded if available. Survival analysis was performed only on p53 abnormal molecular subtypes. Results: A significant number of p53 abnormal cases (24.2%) classified as low grade (FIGO 1 and 2) endometrioid carcinomas. There was no significant difference in survival among different histologic subgroups (p=0.60). There was no significant difference in survival among low grade (FIGO1 or 2) vs high grade (FIGO3) tumors (p=0.98). Low stage (stage I), low grade tumors showed no significant survival advantage over low stage, high grade tumors (p=0.16). Although not statistically significant, the high-grade tumors even showed a trend towards better survival. Low stage patients with high-grade tumors had received more adjuvant treatment than low stage patients with low-grade tumors (p=0.03). Conclusions: The findings of our study support the routine practice of testing all endometrial carcinomas for p53 mutation due significant impact on patients' prognosis and relevance to therapeutic approaches.