SENECA study: staging endometrial cancer based on molecular classification.

Autor:	Chacon E; Department of Gynecologic Oncology, Universidad de Navarra, Pamplona, Navarra, Spain echaconc@unav.es., Boria F; Hospital Universitario Nuestra Senora de la Candelaria, Santa Cruz de Tenerife, Spain., Lyer RR; Department of Gynecologic Oncology, Basavatarakam Indo-American Cancer Institute and Research Centre, Hyderabad, Telangana, India., Fanfani F; Department of Women, Children and Public Health Sciences, Gynecologic Oncology Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy., Malzoni M; Endoscopica Malzoni, Center for Advanced Endoscopic Gynecologic Surgery, Center for Advanced Endoscopic Gynecologic Surgery, Avellino, Italy., Bretová P; Department of Obstetrics and Gynecology, Brno University Hospital, Brno, Czech Republic, Czech Republic., Luzarraga Aznar A; Department of Gynecologic Oncology, Hospital Vall d'Hebron, Barcelona, Spain., Fruscio R; Department of Medicine and Surgery, University of Milan-Bicocca, Milano, Italy.; Clinic of Obstetrics and Gynecology, Hospital San Gerardo, Monza, Italy., Jedryka MA; Department of Oncological Gynecology, Lower Silesian Oncology Center Wrocław, Wroclaw, Poland.; Department of Gynecological Oncology, Wroclaw Medical University, Wroclaw, Poland., Tóth R; Department of Obstetrics and Gynaecology, Semmelweis University, Budapest, Hungary., Perrone AM; Universitaria di Bologna, Bologna, Italy., Kakkos A; Department of Obstetrics and Gynecology, CHU de Liège, Liege, Belgium., Cristóbal Quevedo I; Department of Obstetrics and Gynecology, La Paz University Hospital, Madrid, Madrid, Spain., Congedo L; Department of Woman and Child Health Sciences, University Hospital Agostino Gemelli, Roma, Lazio, Italy.; Department of Gynecologic Oncology; Obstetrics and Gynecology, University Hospitals Leuven, Leuven, Vlaams-Brabant, Belgium., Zanagnolo V; Istituto Europeo di Oncologia, Milano, Anognnn, Italy., Fernandez-Gonzalez S; Department of Gynecology, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain., Ferro B; Department of Obstetrics and Gynecology, Centro Hospitalar e Universitário de Coimbra EPE, Coimbra, Coimbra, Portugal., Narducci F; Department of Gynecology, Centre Oscar Lambret, Lille, France., Hovhannisyan T; Department of Gynecologic Oncology, Nairi Medical Center, Yerevan, Armenia., Aksahin E; Istanbul University-Cerrahpasa Cerrahpasa Faculty of Medicine, Fatih, Istanbul, Turkey., Cardenas L; Gynecologic Oncology Unit, Hospital Universitario de Girona Doctor Josep Trueta, Girona, Catalunya, Spain., Oliver MR; Department of Gynaecologic Oncology, Hospital Universitario 12 de Octubre, Madrid, Spain., Nozaleda G; Department of Obstetrics and Gynecology, Hospital General Universitario Gregorio Marañón, Madrid, Madrid, Spain., Arnaez M; Department of Gynecologic Oncology, University Hospital La Fe, Valencia, Valencia, Spain., Misiek M; Holycross Cancer Center, Kielce, Poland., Ferrero A; Department of Gynecology and Obstetrics, Mauriziano Hospital, Torino, Italy., Pain FA; Department of Obstetrics and Gynecology, Hospital Lariboisière, Paris, France., Zarragoitia J; Hospital Universitari Dexeus, Barcelona, Catalunya, Spain., Diaz C; Department of Obstetrics and Gynecology, Fundación Instituto Valenciano de Oncologia, Valencia, Spain., Ceppi L; ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy., Mehdiyev S; Department of Obstetrics and Gynecology, Bezmialem Vakif Universitesi, Istanbul, Istanbul, Turkey., Roldán-Rivas F; Department of Obstetrics and Gynaecology, Clinico Lozano Blesa Hospital, Zaragoza, Spain.; Universitat de Barcelona, Barcelona, Spain., Guijarro-Campillo AR; Department of Obstetrics and Gynecology, Hospital Clínico Universitario Virgen de la Arrixaca, El Palmar, Spain., Amengual J; Department of Gynaecology, Son Espases University Hospital, Palma de Mallorca, Spain., Manzour N; Departamento de Ginecologia y Obstetricia, Clinica Universidad de Navarra, Pamplona, Navarra, Spain., Sanchez Lorenzo L; Department of Medical Oncology, Clinica Universidad de Navarra, Madrid, Spain., Núñez-Córdoba JM; Clinica Universidad de Navarra, Pamplona, Navarra, Spain., Gonzalez Martin A; Department of Medical Oncology, Clinica Universidad de Navarra, Madrid, Spain., Minguez JA; Department of Gynecology, Clinica Universidad de Navarra, Pamplona, Navarra, Spain., Chiva L; Departamento de Ginecologia y Obstetricia, Clinica Universidad de Navarra, Pamplona, Navarra, Spain.
Jazyk:	angličtina
Zdroj:	International journal of gynecological cancer : official journal of the International Gynecological Cancer Society [Int J Gynecol Cancer] 2024 Sep 02; Vol. 34 (9), pp. 1313-1321. Date of Electronic Publication: 2024 Sep 02.
DOI:	10.1136/ijgc-2024-005711
Abstrakt:	Objective: Management of endometrial cancer is advancing, with accurate staging crucial for guiding treatment decisions. Understanding sentinel lymph node (SLN) involvement rates across molecular subgroups is essential. To evaluate SLN involvement in early-stage (International Federation of Gynecology and Obstetrics 2009 I-II) endometrial cancer, considering molecular subtypes and new European Society of Gynaecological Oncology (ESGO) risk classification. Methods: The SENECA study retrospectively reviewed data from 2139 women with stage I-II endometrial cancer across 66 centers in 16 countries. Patients underwent surgery with SLN assessment following ESGO guidelines between January 2021 and December 2022. Molecular analysis was performed on pre-operative biopsies or hysterectomy specimens. Results: Among the 2139 patients, the molecular subgroups were as follows: 272 (12.7%) p53 abnormal (p53abn, 1191 (55.7%) non-specific molecular profile (NSMP), 581 (27.2%) mismatch repair deficient (MMRd), 95 (4.4%) POLE mutated (POLE-mut). Tracer diffusion was detected in, at least one side, in 97.2% of the cases; with a bilateral diffusion observed in 82.7% of the cases. By ultrastaging (90.7% of the cases) or one-step nucleic acid amplification (198 (9.3%) of the cases), 205 patients were identified with affected sentinel lymph nodes, representing 9.6% of the sample. Of these, 139 (67.8%) had low-volume metastases (including micrometastases, 42.9%; and isolated tumor cells, 24.9%) while 66 (32.2%) had macrometastases. Significant differences in SLN involvement were observed between molecular subtypes, with p53abn and MMRd groups having the highest rates (12.50% and 12.40%, respectively) compared with NSMP (7.80%) and POLE-mut (6.30%), (p=0.004); (p53abn, OR=1.69 (95% CI 1.11 to 2.56), p=0.014; MMRd, OR=1.67 (95% CI 1.21 to 2.31), p=0.002). Differences were also noted among ESGO risk groups (2.84% for low-risk patients, 6.62% for intermediate-risk patients, 21.63% for high-intermediate risk patients, and 22.51% for high-risk patients; p<0.001). Conclusions: Our study reveals significant differences in SLN involvement among patients with early-stage endometrial cancer based on molecular subtypes. This underscores the importance of considering molecular characteristics for accurate staging and optimal management decisions. Competing Interests: Competing interests: None declared. (© IGCS and ESGO 2024. No commercial re-use. See rights and permissions. Published by BMJ.)
Databáze:	MEDLINE
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