Antonio Raffone1, Antonio Travaglino2, Massimo Mascolo3, Luigi Carbone1, Maurizio Guida1, Luigi Insabato3, Fulvio Zullo1. 1. Gynecology and Obstetrics Unit, Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Naples, Italy. 2. Anatomic Pathology Unit, Department of Advanced Biomedical Sciences, School of Medicine, University of Naples Federico II, Naples, Italy. Electronic address: antonio.travaglino@unina.it. 3. Anatomic Pathology Unit, Department of Advanced Biomedical Sciences, School of Medicine, University of Naples Federico II, Naples, Italy.
Abstract
BACKGROUND: After The Cancer Genome Atlas (TCGA) findings, four novel prognostic groups may direct the management of endometrial cancer (EC): POLE-mutated/ultramutated (POLEmt), microsatellite-instable/hypermutated (MSI), copy-number-low/p53-wild-type (p53wt), and copy-number-high/p53-mutated (p53mt). However, data about prognosis in each group are different across the studies, and definitive pooled estimates are lacking after validation series. Such data may be crucial in directing clinical study design and establishing the optimal tailored management of patients. AIM: To provide pooled estimates of hazard ratio (HR) for overall survival (OS), disease-specific survival (DSS), progression-free survival (PFS) in each prognostic group. MATERIALS AND METHODS: A systematic review and meta-analysis was performed by searching 7 electronic databases, from their inception to April 2019, for studies assessing prognosis in each TCGA EC group. Both univariable and multivariable HR analysis was performed for OS, DSS and PFS in each group, using p53wt as reference group. RESULTS: Six studies with 2818 patients were included. Regarding OS, pooled HRs were 3.179 and 1.986 for p53mt group, 1.522 and 1.192 for MSI group, and 0.589 and 0.795 for POLEmt group at univariable and multivariable analyses, respectively. Regarding DSS, pooled HR were 5.052 and 2.133 for p53mt group, 1.965 and 1.068 for MSI group, and 0.552 and 0.325 for POLEmt group at univariable and multivariable analyses, respectively. Regarding PFS, pooled HR were 3.512 and 1.833 for p53mt group, 1.354 and 0.817 for MSI group, and 0.287 and 0.217 for POLEmt group at univariable and multivariable analyses, respectively. CONCLUSIONS: Prognosis of p53mt group is consistently the worst one and is further worsened by unfavorable clinicopathological factors. Prognosis of MSI group overlaps with p53wt group but is worsened by unfavorable clinicopathological factors. Prognosis of POLEmt group is the best one and does not seem to be significantly affected by clinicopathological factors.
BACKGROUND: After The Cancer Genome Atlas (TCGA) findings, four novel prognostic groups may direct the management of endometrial cancer (EC): POLE-mutated/ultramutated (POLEmt), microsatellite-instable/hypermutated (MSI), copy-number-low/p53-wild-type (p53wt), and copy-number-high/p53-mutated (p53mt). However, data about prognosis in each group are different across the studies, and definitive pooled estimates are lacking after validation series. Such data may be crucial in directing clinical study design and establishing the optimal tailored management of patients. AIM: To provide pooled estimates of hazard ratio (HR) for overall survival (OS), disease-specific survival (DSS), progression-free survival (PFS) in each prognostic group. MATERIALS AND METHODS: A systematic review and meta-analysis was performed by searching 7 electronic databases, from their inception to April 2019, for studies assessing prognosis in each TCGA EC group. Both univariable and multivariable HR analysis was performed for OS, DSS and PFS in each group, using p53wt as reference group. RESULTS: Six studies with 2818 patients were included. Regarding OS, pooled HRs were 3.179 and 1.986 for p53mt group, 1.522 and 1.192 for MSI group, and 0.589 and 0.795 for POLEmt group at univariable and multivariable analyses, respectively. Regarding DSS, pooled HR were 5.052 and 2.133 for p53mt group, 1.965 and 1.068 for MSI group, and 0.552 and 0.325 for POLEmt group at univariable and multivariable analyses, respectively. Regarding PFS, pooled HR were 3.512 and 1.833 for p53mt group, 1.354 and 0.817 for MSI group, and 0.287 and 0.217 for POLEmt group at univariable and multivariable analyses, respectively. CONCLUSIONS: Prognosis of p53mt group is consistently the worst one and is further worsened by unfavorable clinicopathological factors. Prognosis of MSI group overlaps with p53wt group but is worsened by unfavorable clinicopathological factors. Prognosis of POLEmt group is the best one and does not seem to be significantly affected by clinicopathological factors.
Authors: Antonio Travaglino; Antonio Raffone; Diego Raimondo; Damiano Arciuolo; Giuseppe Angelico; Michele Valente; Giulia Scaglione; Nicoletta D'alessandris; Paolo Casadio; Frediano Inzani; Antonio Mollo; Angela Santoro; Renato Seracchioli; Gian Franco Zannoni Journal: Int J Gynaecol Obstet Date: 2021-10-11 Impact factor: 4.447
Authors: Margot De Marco; Antonia Falco; Roberta Iaccarino; Antonio Raffone; Antonio Mollo; Maurizio Guida; Alessandra Rosati; Massimiliano Chetta; Giovanni Genovese; Francesco De Caro; Mario Capunzo; Maria Caterina Turco; Vladimir N Uversky; Liberato Marzullo Journal: Br J Cancer Date: 2021-06-07 Impact factor: 9.075
Authors: Diego Raimondo; Antonio Raffone; Antonio Travaglino; Manuela Maletta; Paolo Casadio; Marco Ambrosio; Anna Chiara Aru; Angela Santoro; Gian Franco Zannoni; Luigi Insabato; Antonio Mollo; Fulvio Zullo; Renato Seracchioli Journal: Int J Gynaecol Obstet Date: 2021-07-18 Impact factor: 4.447
Authors: Casper Reijnen; Evangelia Gogou; Nicole C M Visser; Hilde Engerud; Jordache Ramjith; Louis J M van der Putten; Koen van de Vijver; Maria Santacana; Peter Bronsert; Johan Bulten; Marc Hirschfeld; Eva Colas; Antonio Gil-Moreno; Armando Reques; Gemma Mancebo; Camilla Krakstad; Jone Trovik; Ingfrid S Haldorsen; Jutta Huvila; Martin Koskas; Vit Weinberger; Marketa Bednarikova; Jitka Hausnerova; Anneke A M van der Wurff; Xavier Matias-Guiu; Frederic Amant; Leon F A G Massuger; Marc P L M Snijders; Heidi V N Küsters-Vandevelde; Peter J F Lucas; Johanna M A Pijnenborg Journal: PLoS Med Date: 2020-05-15 Impact factor: 11.069