S417
Clinical - Gynaecological
ESTRO 2026
recommendation as per NCCN guidelines(2026) and ESMO guidelines(2022) was assessed. The impact of molecular testing on Stage and Adjuvant treatment was analysed. As ER testing was not done universally risk grouping as per 2025 ESGO/ESTRO/ESCP guidelines could not be done. Results: Total 186 patients data from Stage I-III was available for analysis. 10.8%(10/92) of stage IA patients, 33%(19/57) of Stage IB were upstaged and 19%(4/21) of Stage III patients were downstaged as per FIGO 2023. There was no change in Stage II patients. In stage I disease 14% (21/145) more patients were offered observation, 16%(23/145) less had VBT, 8%(12/145) less had EBRT and 13%(19/145) more had indication for Chemotherapy. In Stage II disease VBT was offered to 37.5%(6/16) instead of EBRT and chemotherapy deescalation was seen in 62.5%(10/16). There was no change in treatment for Stage III disease.
1. NF H. Revised FIGO staging for carcinoma of the vulva. Int J Gynecol Obstet. 2009;105:105-6.2. Berek JS, Matias - Guiu X, Creutzberg C, Fotopoulou C, Gaffney D, Kehoe S, Lindemann K, Mutch D, Concin N, Endometrial Cancer Staging Subcommittee, FIGO Women's Cancer Committee, Berek JS. FIGO staging of endometrial cancer: 2023. International Journal of Gynecology & Obstetrics. 2023 Aug;162(2):383-94.3.Oaknin A, Bosse TJ, Creutzberg CL, Giornelli G, Harter P, Joly F, Lorusso D, Marth C, Makker V, Mirza MR, Ledermann JA. Endometrial cancer: ESMO Clinical Practice Guideline for diagnosis, treatment and follow-up. Annals of oncology. 2022 Sep 1;33(9):860-77. Keywords: Endometrial cancer, Molecular Testing, Stage Addition of Tolinapant to standard radical chemoradiotherapy for locally advanced cervical cancer: CRAIN, a phase 1b TiTE- CRM dose escalation study Peter Hoskin 1 , Geoff Saunders 2 , Marina Lee 3 , Denise Dunkley 3 , Josh Northey 2 , Mary Danh 3 , Emma Tilt 4 , Oliver Edwards 4 , Parys Hatchard 5 , Oliver Dewane 5 , Kate Haslett 1 , Tony Mathew 6 , Vicky McFarlane 7 , Rachel Cooper 8 , Asma Sarwar 9 , Deb Smith 10 , Kimberley Reeves 11 , Ananya Choudhury 1 , Gareth Griffiths 12 1 Clinical oncology, The Christie NHS Foundation Trust, Manchester, United Kingdom. 2 Statistics, Cancer Research UK Southampton Clinical Trials Unit, Digital Poster Highlight 1270 Southampton, United Kingdom. 3 Trial Management, Cancer Research UK Southampton Clinical Trials Unit, Southampton, United Kingdom. 4 Data, Cancer Research UK Southampton Clinical Trials Unit, Southampton, United Kingdom.
Conclusion: Routine molecular testing and the new staging system leads to upstaging of Stage I and downstaging of Stage III disease. RT deescalation was seen in 30% of Stage I and 37.5% of Stage II patients respectively. Chemotherapy escalation was seen in 13% of Stage I patients and deescalation was seen in 62.5% Stage II disease. Our study highlights the impact of molecular testing on treatment and emphasizes its importance in Early Stage Endometrial cancer. References:
5 Monitoring, Cancer Research UK Southampton Clinical Trials Unit,
Southampton, United Kingdom. 6 Clinical oncology, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, United Kingdom.
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