Cancer Of Female Genital Tract Research Articles

Veteran Women Living With Human Immunodeficiency Virus Have Increased Risk of Human Papillomavirus (HPV)-Associated Genital Tract Cancers.

Disparities in access to screening often confound observed differences in human papillomavirus (HPV)-associated female genital tract cancer (FGTC) incidence between women living with human immunodeficiency virus (HIV; WLWH) and their HIV-negative counterparts. We aimed to determine if there have been changes in cancer risk among WLWH during the antiretroviral era in a single-payer health system. We retrospectively selected WLWH and HIV-negative controls receiving care between 1999 and 2016 at the US Department of Veterans Affairs (VA) and identified FGTC diagnoses via Cancer Registry and International Classification of Diseases-9/10 codes. We extracted demographic and clinical variables from the VA's Corporate Data Warehouse; evaluated incidence rates (IRs), incidence rate ratios, hazard ratios, and 95% confidence intervals (CIs) for cancer risk; and conducted survival analyses. We identified 1454 WLWH and compared them with 5816 matched HIV-negative controls. More WLWH developed HPV-associated FGTCs (total n = 28 [2.0%]; cervical = 22, vulvovaginal = 4, and anal/rectal = 2) than HIV-negative women (total n = 32 [0.6%]; cervical = 24, vulvovaginal = 5, and anal/rectal = 5) (log rank P < .0001). Cervical cancer IR was >6-fold higher for WLWH (204.2 per 100 000 person-years [py] [95% CI, 83.8-324.7]) than HIV-negative women (IR = 31.2 per 100 000 py [95% CI, 17.9-44.5]). The IRs for vulvovaginal and anal cancers were also higher in WLWH. Overall, WLWH were more likely to develop HPV-associated FGTCs compared with their HIV-negative counterparts (all log rank P values < .0001). Veteran WLWH are more likely to develop HPV-associated FGTCs despite equal access to health care. Even in single-payer health systems, WLWH continue to require special attention to ensure guideline-based high-risk HPV screening for prevention of FGTCs.

Cost-Effectiveness of Early Detection and Prevention Strategies for Endometrial Cancer-A Systematic Review.

Endometrial cancer is the most common female genital tract cancer in developed countries. We systematically reviewed the current health-economic evidence on early detection and prevention strategies for endometrial cancer based on a search in relevant databases (Medline/Embase/Cochrane Library/CRD/EconLit). Study characteristics and results including life-years gained (LYG), quality-adjusted life-years (QALY) gained, and incremental cost-effectiveness ratios (ICERs) were summarized in standardized evidence tables. Economic results were transformed into 2019 euros using standard conversion methods (GDP-PPP, CPI). Seven studies were included, evaluating (1) screening for endometrial cancer in women with different risk profiles, (2) risk-reducing interventions for women at increased or high risk for endometrial cancer, and (3) genetic testing for germline mutations followed by risk-reducing interventions for diagnosed mutation carriers. Compared to no screening, screening with transvaginal sonography (TVS), biomarker CA-125, and endometrial biopsy yielded an ICER of 43,600 EUR/LYG (95,800 EUR/QALY) in women with Lynch syndrome at high endometrial cancer risk. For women considering prophylactic surgery, surgery was more effective and less costly than screening. In obese women, prevention using Levonorgestrel as of age 30 for five years had an ICER of 72,000 EUR/LYG; the ICER for using oral contraceptives for five years as of age 50 was 450,000 EUR/LYG. Genetic testing for mutations in women at increased risk for carrying a mutation followed by risk-reducing surgery yielded ICERs below 40,000 EUR/QALY. Based on study results, preventive surgery in mutation carriers and genetic testing in women at increased risk for mutations are cost-effective. Except for high-risk women, screening using TVS and endometrial biopsy is not cost-effective and may lead to overtreatment. Model-based analyses indicate that future biomarker screening in women at increased risk for cancer may be cost-effective, dependent on high test accuracy and moderate test costs. Future research should reveal risk-adapted early detection and prevention strategies for endometrial cancer.

ROLE OF CYTOLOGY AND COLPOSCOPY DIRECTED BIOPSY IN EVALUATION OF CLINICALLY SUSPICIOUS CERVIX

Background: Cervical cancer is the second most common cancer among women in developing countries. Cervical cancer is a deadly disease once it reaches the invasive stages but out of all the female genital tract cancers, it is the only preventable cancer if detected in its early stages and the disease is almost 100% curable with accurate screening and early detection. Traditional screening for cervical cancer is done with papanicolaou smear test, colposcopic examination and colposcopic directed biopsy for histopathology. Obejective: To evaluate efficacy of both cytology and colposcopy directed biopsy in evaluation of clinically suspicious cervix. Patients and Methods: Cross sectional study on 300 patients with clinically suspicious cervix attending the outpatient Department of Obstetrics and Gynecology, at the Hospital of Al-Azher Assiut University. Results: Pap smear had a sensitivity of 25.5% and a specificity of 87% which was attributed to the high number of false negative smears. Accuracy of pap smear was 76.7%. Colposcopy showed a sensitivity of 82% and a specificity of 81%. Sensitivity was more than pap smear but specificity was less than pap smear. * Accuracy of colposcopy was found to be 81% which was comparatively more than that of pap smear (77%). Conclusion: It is evident that colposcopy is definitely more sensitive and accurate than pap smear. By combining pap smear with colposcopy, we can maximize the sensitivity and specificity of cancer cervix screening. Both the result of cytology and colposcopy should be compared to those of histopathology, that histopathology remain the main method of diagnosing the precursors of neoplastic cervical lesion.

ROLE OF CYTOLOGY AND COLPOSCOPY DIRECTED BIOPSY IN EVALUATION OF CLINICALLY SUSPICIOUS CERVIX

Background: Cervical cancer is the second most common cancer among women in developing countries. Cervical cancer is a deadly disease once it reaches the invasive stages but out of all the female genital tract cancers, it is the only preventable cancer if detected in its early stages and the disease is almost 100% curable with accurate screening and early detection. Traditional screening for cervical cancer is done with papanicolaou smear test, colposcopic examination and colposcopic directed biopsy for histopathology. Obejective: To evaluate efficacy of both cytology and colposcopy directed biopsy in evaluation of clinically suspicious cervix. Patients and Methods: Cross sectional study on 300 patients with clinically suspicious cervix attending the outpatient Department of Obstetrics and Gynecology, at the Hospital of Al-Azher Assiut University. Results: Pap smear had a sensitivity of 25.5% and a specificity of 87% which was attributed to the high number of false negative smears. Accuracy of pap smear was 76.7%. Colposcopy showed a sensitivity of 82% and a specificity of 81%. Sensitivity was more than pap smear but specificity was less than pap smear. * Accuracy of colposcopy was found to be 81% which was comparatively more than that of pap smear (77%). Conclusion: It is evident that colposcopy is definitely more sensitive and accurate than pap smear. By combining pap smear with colposcopy, we can maximize the sensitivity and specificity of cancer cervix screening. Both the result of cytology and colposcopy should be compared to those of histopathology, that histopathology remain the main method of diagnosing the precursors of neoplastic cervical lesion.

Rare Malignancies of the Female Genital Tract

Aims: To analyze rare female genital tract malignancies.&#x0D; Method: This is retrospective descriptive study as a census of all rare female genital tract malignancies in two years from 2017 to 2019 at Paropakar Maternity and Women’s Hospital in Kathmandu. Data were retrieved from medical record and entered into Microsoft Excel and SPSS 16 window for analysis.&#x0D; Results: There were 156 cases of female genital tract malignancies including 128 common types and 28 rare types. Majority fell under 41- 50 years (n=44; 28.2%) followed by over 60 (n=41; 26.2%) and 51-60 years (n=34; 21.8%). Among ovarian tumors, the rare varieties were adult granulosa cell tumor (n=4), immature teratoma (n=3) and single case each of yolk sac tumor, dysgerminoma, malignant mixed germ cell tumor, carcinoid tumor, juvenile granulosa cell and sertoli cell tumor. There were one case each of carcinosarcoma, serous carcinoma and endometrial stromal carcinoma; two cases each of leiomyosarcoma and choriocarcinoma while there was a single case of placental site trophoblastic tumor. The rare cervical malignancies were small cell (n=2), and clear cell carcinoma (n=1). There were single cases each of basal cell carcinoma of vulva, verrucus carcinoma, fibromyxoid sarcoma of Bartholin’s gland and malignant melanoma of vagina.&#x0D; Conclusion: Rare female genital tract cancers were found mostly from the ovary followed by uterus; 18% of total cancers were rare types.&#x0D; Key words: female, genital tract, rare malignancy

Female Lower Genital Tract Cancer Prevention

Female lower genital tract cancers ranks fourth common among all female cancers. They comprises cervical, vaginal, and vulvar cancers. They also share common carcinogenic causes which are oncogenic human papillomaviruses (HPV) infections. Therefore, similar ways of prevention could be applied to these cancers. Those are primary, secondary, and tertiary preventions. Primary prevention comprises preventing HPV transmission and preventive immunization against HPV. Secondary prevention comprises early detection of precancerous lesions by screening means in combination with treatment of the precancerous lesions detected. Vulvar lesion might be seen by a woman herself, however, health personnel are definitely better in doing that during a routine check-up visit for cervical cancer. Tertiary prevention comprises early diagnosis, staging, and effective treatment to these cancers. Although cervical and vaginal cancers still use clinical staging, radiologic and pathologic data has been integrated since 2018. Vulvar cancer has been surgically staged since 1988, and its staging also has been updated in 2018. By using effective primary and secondary prevention, the incidences of these cancers would be decreased. By using effective tertiary prevention, the persistent (resistant/ refractory) or recurrent rates would be decreased.

Fibroblast growth factor receptor signaling as therapeutic targets in female reproductive system cancers.

Ovarian cancer, cervical cancer and endometrial cancer are three relatively common malignant cancers of the female reproductive system. Despite improvements in female genital tract cancer detection and development of new therapeutic approaches, there are still poor prognoses and some do not respond to therapeutic patterns, displaying low survival and high frequency of recurrence. In an era of personalized medicine, novel therapeutic approaches with greater efficacy for these cancers represent an unmet need. One of the actionable signaling pathways is the fibroblast growth factor receptor (FGFR) signaling pathway. Several mutations and alterations in FGF/FGFR family members have been reported in human cancers. FGF/FGFR signaling pathway has become a new target for cancer therapy. This review will summarize the role of FGFR pathway and the genetic alterations of the FGF/FGFR related to female reproductive system cancer. We will describe the available inhibitors of FGFR pathway for potential treatment of female reproductive system cancer. Furthermore, we will discuss FGFR-targeted therapies under clinical development for treatment of female reproductive system cancer.

Comparison of Cancer Occurance among AYA (Adolescent and Young Adult) Cancer, Adult Cancer and Geriatric Cancer

Abstract Background Cancers are increasing day by day but there is a few data regarding ratios of cancers between AYA cancers, Adult cancers and Geriatric cancers. Aimed of the study was find out disease patterns of cancers with their relation with age group, sex ratio and histology. Methods The study was an observational study. All histologically confirmed cancer patients aged 15years and above registered at medical oncology department in National Institute of Cancer Research &Hospital (NICRH) from January 2010 to December 2018(9 years) were included. The patients, 15 -39 years were grouped as AYA, 40- 64 years were as Adult and aged 65 years or more were Geriatric. Records of patient were taken from the documents of medical oncology of NICRH,Dhaka. Diseases were retrospectively studied. Results Total 39422 patients were enrolled for this study. Of them, male(M) 22445(56.94%), female(F) 16977(43.06%) and M: F was 1.32:1. Adult patients was most common, 23883(60.58%) followed by Geriatric patients ,7923(20.10%) and AYA, 7616(19.32%). The ratios between AYA: Adult:Geriatric were 1:3.13:1.04. The leading five cancers in adults were lung cancers 8715(36.50%) followed by Gastrointestinal tract (GIT) cancers 6480(27.13%), Breast cancers 3618(15.15%), Female genital tract (FGT) cancers 2200(9.21%) and Head neck cancers(HNC) 1367(5.72%). The leading cancers in geriatrics were lung cancers 4175(52.70%) followed by GIT cancers 1118(14.11%), Breast cancers 738(9.31%), HNC 494(6.24%) and Urological malignancy 418(5.30%). The leading cancers in AYA were GIT cancers 1897(24.91%) followed by Breast cancers 1863(24.50%), Lung cancers 1052(13.80%), Sarcoma 707(9.30%) and FGT cancers 664(8.72%). Conclusion Cancers mostly affect adults, though AYA and Geriatrics are nearly equally affected. The five most common cancers were lung cancer 12653(32.10%) followed by GIT cancers 9250(23.50%), Breast cancers 6562(16.65%), FGT cancers 3092(7.84%) and HNC 2422(6.14%).

Uterine Sarcomas: Surgical Management, Adjuvant Therapy and Survival Outcome. Experience at Gujarat Cancer and Research Institute

Uterine sarcomas are rare, accounting for 7–8% of all uterine cancers and less than 1% of all female genital tract cancers. Surgery is a cornerstone in the treatment, and addition of radiotherapy, chemotherapy or hormonal therapy depends on the stage of the disease. Due to its rarity, heterogeneity and aggressiveness, there is no consensus and there is scarce evidence regarding the optimal therapeutic approaches. Our aim was to study the cases of uterine sarcoma in terms of clinical and histopathological characteristics, prognostic factors and outcome analysis. This is a retrospective study of all cases of histological proven uterine sarcoma identified between January 2001 and December 2013 at the Department of Gynecologic Oncology, Gujarat Cancer and Research Institute, Ahmedabad. The data regarding the patients’ characteristics, tumor characteristics, various treatment modalities, operative details, follow-up, recurrence and survival were reviewed and recorded. Total 57 were included in our study. Leiomyosarcoma was the most common histopathological type. Twenty-four cases were stage 1 and were kept on observation. Almost 50% of the patients in our study recurred during our study period. Overall 64% of the patients survived till 3 years and 53% till 5 years of follow-up. Twenty-six percent of the case died within first year of completion of treatment. The management of uterine sarcomas is challenging due to the rare occurrence, lack of consensus or guidelines and adequate literature. Adjuvant treatment should be individualized.

Targeted therapy with monoclonal antibodies: Do we observe progress in the management of female genital tract cancers?

Targeted therapy with monoclonal antibodies (moAbs) has become a valuable supplementation for classic chemo- and radiotherapy. The first part of this review presents in a condensed way the characteristics and mechanism of action of moAbs most commonly used and/or tested for therapy of female genital tract malignancies, including: bevacizumab (anti-VEGF-A moAb), cetuximab (anti-EGFR moAb), trastuzumab (anti-ErbB2/HER2 moAb), catumaxomab (anti-EpCAM/anti-CD3 moAb), oregovomab (anti-MUC16 moAb) and farletuzumab (anti-FR-α moAb). The second part of the review discusses the results of the recent clinical trials devoted to the usefulness of moAbs in the management of cervical, endometrial and ovarian cancers. The unquestionable progress in this field has made possible the introduction of bevacizumab for the treatment of advanced ovarian, Fallopian tube or peritoneal cancer, as well as advanced, recurrent or metastatic cervical cancer. Similarly, catumaxomab has been registered for the intraperitoneal treatment of malignant ascites in EpCAM positive ovarian cancer when standard therapy is no longer available.

Neoplasia and Precursor Lesions of the Female Genital Tract in IBD: Epidemiology, Role of Immunosuppressants, and Clinical Implications.

In this review the risk of breast, ovarian, and endometrial cancer and cervical and vulvovaginal (pre)malignant abnormalities in patients with inflammatory bowel disease (IBD) with or without immune suppressive treatment will be discussed. So far, this has not been studied thoroughly and large studies taking into account diverse potential confounding factors are lacking. IBD per se has not been associated with development of cervical cancer, yet patients with Crohn's disease who smoke, have a younger age at diagnosis or who use(d) thiopurines might be more at risk. Other immunosuppressive medication seems not to increase this risk, however, as evidence at this point is incomplete, physician awareness and prevention by lifestyle counseling, HPV vaccination and (intensified) screening are warranted. The risk for breast, endometrial, ovarian, and vulvovaginal cancer in IBD patients appears to be comparable to the background population, although for breast cancer this may even be decreasedin Crohn's disease specifically. Immunosuppressive medication in general does not seem to alter this risk. Earlier and more frequent screening for breast cancer than currently conducted in general nationwide screening programs is not recommended at this moment. Current literature suggests a much lower overall malignancy recurrence rate in IBD patients than has been observed previously. More importantly, immune suppressive medication does not appear to increase the recurrence risk. Robust epidemiologic data on female genital tract cancer are needed.

The Pathways in Endometrial Carcinogenesis and an Overview of its Histology, Grade and Stage

Endometrial carcinoma is the most common female genital tract cancer in the developed countries. It is classified as Type I and II endometrial cancer. Understanding of the pathogenesis of each type plays a pivotal role in identifying their precursors. The histological subtype, grade and stage guide the treatment strategies and portend the prognosis in endometrial carcinoma. Hysterectomy is regarded curative in early stage disease. By contrast, uterine serous carcinoma is the most aggressive histologic subtype associated with a low 5-year overall survival rate. Substantial rise in uterine corpus carcinoma parallels with the increase in obesity and diabetes. As they share similar etiologies, measures can be adopted to tackle the modifiable risk factors. No screening consensus is available for low or average risk populations.

Awareness and screening practices of cervical cancer among nursing staff working in tertiary care hospital

Background: In India there are an estimated of 1,32,000 new cases and 74,000 deaths each year of cervical cancer. Out of all the female genital tract cancers, it is the only pre­ventable cancer if detected at its early stages. More than one fifth of all new cases are diagnosed in India due to a lack of screening that allows detection of precancerous and early stage cervical cancer. Staff nurses if trained properly, can make aware and screen all the women coming to detect suspicious cases. The present study was carried to assess knowledge regarding cervical cancer, screening procedures and attitude and practices regarding prevention and screening of cervical cancer among nursing staff.Methods: A cross-sectional study was carried out among the nursing staff between March to June 2016. A total of 215 nursing staff was enrolled in the study.Results: Majority 75 (34.88%) of the participants were from 41-50 years of age and 147 (67.90%) were married. The majority of the participants received information about cervical cancer and screening from hospital 135 (71.05%) and 40 (21.05%) from the newspaper. Majority of females 68 (35.78%) said HPV infection as major risk factor for cervical cancer. Majority of the females 125 (65.78%) mentioned that discharge p/v is the main symptom. Majority of the participants 66 (38.82%) replied that married Women and sexually active 54 (31.76%) women must be screened.Conclusions: It can be concluded that presently the knowledge and understanding of cervical cancer, as well as its screening process, is satisfactory, but there is a vast scope for improvement.

Advances in the research of HPV and cervical cancer and precancerous lesions

High-risk Human papilloma virus (HR-HPV) has been identified as a necessary factor for the development of precancerous lesions and invasive carcinoma of the genital tract, among which cervical cancer is the most common cancer in the female genital tract. The molecular biological mechanism of HPV leading to malignant transformation of cervix and the epidemiological information of HPV provide us with many strategies for early detection and early intervention of cervical lesions. In recent years, the incidence and mortality of cervical cancer in our country had the trend of increasing. This article reviews the research progress of HPV and cervical cancer and precancerous lesion. Key words: Papillomaviridae; Uterine cervical neoplasms; Review

Primary Fallopian Tube Carcinoma Presenting with Isolated Controlateral Inguinal Lymphadenopathy

Primary fallopian tube carcinoma is a rare tumor accounting for <1% of all female genital tract cancers. Presentation primarily as inguinal lymphadenopathy alone is rare. We report a case of a 57-year postmenopausal woman who presented with seven months history of swelling in the right groin, excised and confirmed to be metastatic adenocarcinoma. CA-125 was elevated with a value of 960 U/ml. An exploratory laparoscopy was done, with total abdominal hysterectomy, omentectomy, and appendicectomy, without lymph node dissection. Uterus, right fallopian tube, and ovaries were normal. The left fallopian tube was distended with a mass of 6x5 cm. Histology of left fallopian tube revealed high-grade adenocarcinoma with malignant peritoneal cytology. Histology of right fallopian tube and other structures was normal. The patient received four cycles of adjuvant carboplatin plus taxol with good biological and radiological response. She was referred to our institute for a second look surgery and lymph node dissection. Two months after the end of chemotherapy, she underwent the second surgery consisting of a pelvic, para-aortic and right inguinal lymphadenectomy with a sample from the left inguinal node. There were two metastatic nodes. The patient received six other cycles of carboplatin plus taxol. At present, she remains well, and CA-125 is normal. Fallopian tube adenocarcinoma rarely presents as metastatic inguinal lymphadenectomy. The management of this malignancy is generally the same as epithelial ovarian cancer.

1815 - Sensor-controlled scalp cooling in the clinical routine: an effective and safe method to prevent chemotherapy-induced alopecia in women with breast or female genital tract cancer

1815 - Sensor-controlled scalp cooling in the clinical routine: an effective and safe method to prevent chemotherapy-induced alopecia in women with breast or female genital tract cancer

1492P - Prevention of chemotherapy-induced alopecia in patients with breast or female genital tract cancer using sensor-controlled scalp-cooling

Chemotherapy (Ctx)-induced alopecia (CIA), produces a deep psychological impact in many women involved. Although sensor-controlled scalp cooling (SCSC) is effective in preventing CIA, it is infrequently used in many countries due to physicianś concerns regarding both safety and feasibility. This retrospective analysis was initiated to obtain detailed information about the effectiveness and safety of SCSC using the Paxman system (Paxman, Huddersfield, UK) in female patients (pts) exposed to CIA-inducing Ctx for breast cancer (BC) or genital tract malignancies in the clinical routine. 87 pts who underwent SCSC alongside Ctx from 2014-2016 were identified from our database: BC, 68; epithelial ovarian carcinoma, 14; others, 5; premenopausal, 42; postmenopausal, 45. 63 pts were treated in a curative intent, 24 were treated in a palliative setting; 57 pts were Ctx-naïve, 30 pts had a history of prior Ctx. The following Ctx regimens were used: anthracycline-based (A), 4; taxane-based (T), 21; AT-based, 48; others, 14. Pts were subjected to SCSC during each Ctx cycle. CIA was quantified according to the Dean score (DS) determined 3 wks after the last Ctx cycle. Data were analyzed regarding feasibility indicated by the SCSC completion rate, quality of hair preservation (success: DS 0-2, failure: DS 3-4), reasons of SCSC discontinuation, and safety. 57 pts (64.5%) completed SCSC, with 47 (53.0%) experiencing complete hair preservation (DS 0), and 10 (11.5%) showing partial success (DS 1-2). 30 pts (35.5%) discontinued SCSC, with CIA being the main reason in 21 pts (24.1%). Headache was reported in 4 (5.0%), and local discomfort ("feeling cold") in 3 pts (3.4%). In 2 pts (2.3%), the reason of discontinuation remained unclear. Side effects were all not severe and resolved completely after cessation of SCSC. In the clinical routine, SCSC using the Paxman system is feasible, safe and effective in order to prevent CIA in pts with BC and female genital tract carcinomas. The treatment success rate in our study is in good agreement with previous reports on SCSC although more pts in the palliative setting or with a history of prior Ctx have been included.

Clinicopathological Study of Angiogenesis in Gastric Cancer

Angiogenesis has been proposed as a prognostic marker in a variety of human malignancies-including colon, lung, breast, renal, glioblastoma, the female genital tract, prostate, melanoma, and other cancer. Several previous studies showed expression of VEGF-A in tumor cells of gastric carcinomas and correlations of VEGF-A with the micro vessel density (MVD). However, there are contradictory results as far as it concerns the prognostic value of VEGF-A, its receptors and MVD. However, in the case of gastric cancer, vessels in different tumor subtypes have been counted based on immunostaining with different antibodies marking endothelial cells.

Synchronous Primary Carcinomas of Cervix and Ovary: A Case Report

Synchronous tumors occur rarely in female genital tract, though it is one among potential sites for synchronous malignancies. In our case report a 36 year old female is diagnosed with two primary malignancies simultaneously; squamous cell carcinoma cervix and bilateral papillary cystadenocarcinoma ovary. Their distinct histological features and sparing of uterine corpus and fallopian tube helped in establishing the diagnosis as two separate primaries rather as metastatic spread of one primary malignancy. The objective is to strengthen the suggestion of thorough evaluation of whole female genital tract in case of suspected tumor, as secondary Mullerian system theory explains the possibility of synchronous cancer in female genital tract.

Abstract 162: Genomic analysis of uterine aspirates improves diagnosis and captures the intratumor heterogeneity in endometrial cancer

Abstract Background: Endometrial cancer (EC) is the most common cancer in female genital tract in developed countries. Although the majority of ECs are diagnosed in early stages, with a 5-year overall survival of around 80%, an early detection of these tumors is crucial to increase survival of patients given that advanced tumors are associated with poorer outcome. Furthermore, the correct assessment of pre-clinical diagnosis is also decisive to guide the surgical management and treatment of the patient. Results: Genetic analysis of uterine aspirates identifies the mutational profile of endometrial cancers and represents the intra-tumor heterogeneity found in the analysis of multiple tumor regions from hysterectomy. Conclusions: The current study reveals the potential of the genetic analysis of uterine aspirates as a pre-operative tool to diagnosis, even in biopsies with insufficient material, with a sensitivity of 93.7% and a specificity of 91.7%. Additionally, genetic analysis of uterine aspirates allows to capture the intra-tumor heterogeneity identified in ECs. Citation Format: Alba Mota, Eva Colas, Pablo Garcia-Sanz, Irene Campoy, Alejandro Rojo-Sebastian, Luis Chiva, Sonsoles Alonso, Sonia Gatius, Antonio Gil-Moreno, Xavier González-Tallada, Berta Díaz-Feijoo, Patrycja Ziober Malinwska, Marcin Bobiński, Jaume Reventos, Xavier Matias-Guiu, Gema Moreno-Bueno. Genomic analysis of uterine aspirates improves diagnosis and captures the intratumor heterogeneity in endometrial cancer. [abstract]. In: Proceedings of the 107th Annual Meeting of the American Association for Cancer Research; 2016 Apr 16-20; New Orleans, LA. Philadelphia (PA): AACR; Cancer Res 2016;76(14 Suppl):Abstract nr 162.