ESTRO 2022 - Abstract Book

S808

Abstract book

ESTRO 2022

Conclusion Stage migration of cervical cancer from FIGO2009 to FIGO2018 contributed significantly different distant metastasis-free survival among patients with stage IIIB but not for stage IIB; whereas, local control, nodal control, and overall survival between FIGO2018 stage IIIC and IIB-IIIB were found no significant difference. The predominant site of failure was similar among different FIGO staging which was distant metastasis.

PD-0912 Molecular Resistance Mechanisms in the Treatment of Locally Advanced Cervical Cancer: HIF-1 α ? ERCC1?

F. Sert 1 , G. Serin 2 , M. Ozturk 1 , O. Zekioglu 2 , S. Alanyali 1 , Z. Ozsaran 1

1 Ege University Faculty of Medicine, Radiation Oncology, Izmir, Turkey; 2 Ege University Faculty of Medicine, Medical Pathology, Izmir, Turkey Purpose or Objective The objective of this study was to assess the association between pretreatment hypoxia inducible factor 1 α (HIF-1 α ) and Excision Repair Cross-Complement 1 (ERCC1) expression in locally advanced cervical cancer patients treated definitively with concurrent chemoradiation therapy (CRT) and treatment outcomes including overall survival (OS), local recurrence- free survival (LRFS), and distant metastasis-free survival (DMFS). Materials and Methods HIF-1 α and ERCC1 protein expressions of totally 87 patients treated definitely wit CRT were evaluated and preparations were scored semi-quantitatively by 2 pathologists blinded to the treatment results. Results were grouped according to HIF- 1 α (H-score: ≤ 100 and >100) and ERCC-1 (H-score: ≤ 130 and >130) H-scores, taking into account the Reciever Operating Characteristic (ROC) curves. The OS, LRFS, and DMFS rates were calculated using the Kaplan-Meier method and the differences between the groups were evaluated by log-rank and cox regression analysis. Results The median age of the included patients was 57 (range, 37, and 85), their distribution by FIGO2018 staging for 1B3, 2A, 2B, 3A, 3B, 3C1, 3C2, and 4A were 4.6%, 13.8%, 28.7%, 1.1%, 5.7%, 28.7%, 2.2%, and 13.8%, respectively. While 95% of the pathologies are squamous cell carcinoma, only 5% are adenosquamous cell carcinoma, no lymph node metastasis (LNM) has been reported in 60% of the patients. The rates of 5-y OS, LRFS and DMFS for the whole group were 57.8%, 69.7% and 69.1%, respectively. For HIF 1 α H-score ≤ 100 and >100, the 5-year OS (48.8% and 47.2%, p=0.467), LRFS (67.8% and 68.4%, p=0.979), and DMFS (59.1% and 67.1%, p=0.224) were not significantly different. For ERCC-1 H-score ≤ 130 and >130, the 5-year OS (56.7% and 54.6%, p=0.463) and DMFS (68.0% and 62.9%, p=0.896) were not significantly different. But the patients with H- score ≤ 130 had statistically better LRFS rates than the patients with >130 H-score (83.8% and 57.4%, p=0.024). In multivariate analysis, having neutrophil-to-lymphocyte ratio >2.5 (p=0.042), presence of LNM (p=0.051), and no response to treatment (p<0.001) were unfavorable factors for OS; >4 cm tumor size (p=0.048), no response to the treatment (p<0.001), and >130 ERCC-1 H-score (p=0.032) were unfavorable factors for LRFS; no response to the treatment (p<0.001) were the only unfavorable factor for DMFS. Conclusion HIF-1 α expression has not been found to be successful in predicting treatment response or outcomes in cervical cancer treated with definitive CRT. However, ERCC-1 high staining has been shown to be an unfavorable prognostic factor for LRFS. It is thought that it would be useful to carry out further studies to select different radiosensitizing agents other than platinum in the use of concurrent chemotherapy with RT in patients with high ERCC-1 expression. P. PIFER 1 , S. Jaishankar 1 , R. Bhargava 2 , A. Keller 1 , H.B. Musunuru 1 , M. Cohen 3 , P. Sukumvanich 4 , M. Courtney-Brooks 4 , M. Boisen 5 , J. Berger 6 , S. Taylor 6 , A. Olawaiye 3 , J. Lesnock 3 , R. Edwards 3 , J.A. Vargo 1 , S. Beriwal 7,8 1 UPMC Hillman Cancer Center, Radiation Oncology, Pittsburgh, USA; 2 Magee-Women’s Hospital, Pathology, Pittsburgh, USA; 3 Magee-Women’s Hospital, Gynecologic Oncology, Pittsburgh, USA; 4 Magee-Women’s Hospital , Gynecologic Oncology, Pittsburgh, USA; 5 Magee-Women’s Hospital, Gynecologic Oncology, Pittsburgh, USA; 6 Magee-Women’s Hospital , Gynecologic Oncology, Pittsburgh, USA; 7 Allegheny Health Network Cancer Institute, Radiation Oncology, Pittsburgh, USA; 8 Varian Medical Systems, Radiation Oncology, Charlottesville, USA Purpose or Objective Lymphovascular space invasion (LVSI) predicts for higher rates of recurrence and increased mortality in endometrial cancer. Using three-tier LVSI scoring, a pooled analysis of the PORTEC 1&2 trials demonstrated that substantial LVSI was associated with worse locoregional- and distant disease-free survival, and these patients possibly benefited from EBRT. In patients with lymph node (LN) evaluation, substantial LVSI is a predictor for LN involvement. However, it is unknown if the significance of substantial LVSI remains in patients with a pathological negative LN assessment. We therefore aimed to evaluate clinical outcomes of patients with pathological negative LN assessment in relation to three-tier LVSI scoring system. Materials and Methods We performed a single-institutional retrospective review of patients with Stage I endometrioid-type endometrial cancer who underwent surgical staging with pathological negative LN evaluation from July 2017 - September 2019. Three-tier LVSI scoring (none, focal, or substantial) was performed by gynecologic pathologists. Patients with ITCs were included. Patients PD-0913 Is substantial LVSI prognostic in patients with pathological lymph node-negative endometrial cancer?