Practical lessons learned from real-world implementation of the molecular classification for endometrial carcinoma

• Type: Article in International Scientific Journal
• Date: 2023

Authors

Moreira, I (Author) Other; Ferreira, M (Author) Other; Garcia, S (Author) Other; Novais, P (Author) Other; Gama, J (Author) Other; Ferro, B (Author) Other; Leite Silva, P (Author) Other; Frutuoso, C (Author) Other; Pires, M (Author) Other; Barbosa, A (Author) Other; Pinto, C (Author) Other; Manuel R Teixeira (Author) ICBAS; Pereira, D (Author) Other; Bartosch, C (Author) Other

Journal

Title: Gynecologic Oncology

Vol. 176

Pages: 53-61

ISSN: 0090-8258

Publisher: Elsevier

Indexing

ISI Web of Knowledge - 0 Citations

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Other information

Authenticus ID: P-00Y-R44

DOI: 10.1016/j.ygyno.2023.07.005

Abstract (EN): Objectives. This study aimed to explore the practical organisational aspects and difficulties in the implemen-tation of the molecular classification of endometrial carcinoma (EC), and to demonstrate its potential impact in prognostic risk group classification. Methods. We conducted a multicentre, retrospective cohort study of 230 patients with EC diagnosed between 2019 and 2022. Sample processing, clinicopathological, treatment and follow-up data were collected. Molecular classification was obtained by p53 and mismatch repair proteins immunohistochemistry, and POLE next -generation sequencing.Results. Implementation was achieved through centralization of molecular analysis. In practice, it was possible to optimise turnaround times of complete integrative reports for hysterectomy specimens to a median time of 18 workdays. If genetic study was started in endometrial biopsies before surgery, 82.0% were available at the time of multidisciplinary tumour board, compared to 8.4% if performed in hysterectomy. ECs were classified as follows: 37.8% no specific molecular profile, 31.7% p53 abnormal, 24.3% mismatch repair deficient, and 6.1% POLE mutant. Integration of these results with traditional clinicopathologic factors led to a change in prognostic risk group in 15 (6.5%) patients, most being initially allocated to high-intermediate (n = 8) and low (n = 5) risk groups. Eight patients changed to a higher risk, and 7 to a lower risk group, whereas 2 remained in the same group. Conclusions. Centralization of EC molecular classification is a feasible option for countries with limited resources. Optimization of workflows may be achieved by earlier analysis in biopsies and prioritisation of patients whose results imply changes in risk group classification. & COPY; 2023 Published by Elsevier Inc.

Language: English

Type (Professor's evaluation): Scientific

No. of pages: 9