Abstract
e15572 Background: EC is the most common gynecologic tumor. Although overall survival (OS) is greater than 80%, a subgroup of patients (pts) has a poorer prognosis. Different MFs have been described in EC. PTEN loss and PIK3CA mutations (mut) are the most frequent up to 70%. Currently, there are paucity data of their clinical outcome influence. We have determined PTEN loss and PIK3CA mut in an EC pts cohort to correlate these findings with established prognostic factors and OS. Methods: Formalin-fixed paraffin-embedded tissue of 42 consecutive EC pts treated between 2001 and 2010 were obtained. PTEN loss expression (Hscore≤50) and PIK3CA mut were evaluated by inmunohistochemistry and Sequenom MassARRAY system respectively. Clinical and pathological data were reviewed from medical records. Statistical methods included univariate and multivariate analysis (Histological Type, Tumor grade, FIGO Stage and MFs). Results: A total of 42 pts were analyzed: 21 (50%) Type I (endometrioid) and 21 (50%) Type II (17 Serous-papillary and 4 clear cell) histology. Median age was 62 y (33-79). Sixteen (38%) and 26 pts (62%) were FIGO stage I-II and III-IV respectively. Thirty pts (77%) had grade 3 tumor. All pts but one were initially treated with surgery, 8 pts received adjuvant chemotherapy, 12 pelvic radiotherapy and 15 both. Regarding MFs, 17 pts (41%) had PTEN loss, 5 (12%) PIK3CA mut and 11 (26%) had both. Seven PIK3CA mut were identified, being R88Q the most frequent (31%). Molecular findings were balanced between early and advanced stages (80% and 81% respectively). Median OS was 41 m (27-56). Analyzing OS regarding clinical and molecular features, only the presence of PTEN loss and/or PIK3CA mut has a negative impact. An alteration in the PI3K pathway does not reached statistical significance for OS in the univariate (p=0.059) but it does in the multivariate model (p=0.025, CI 0.020- 0.765). Median OS was 33 m (16-50) and 45 m in the group with and without molecular changes respectively. Conclusions: In our EC cohort, OS is influenced by molecular changes in PI3K pathway reaching statistical significance. Although there could be a bias due to the sample size, our findings warrant further investigation.
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